Effect of glutamine on intestinal permeability and bacterial translocation in patients with intestinal obstruction

Objective: To investigate the relationship between changes in intestinal permeability and bacterial translocation in patients with intestinal obstruction;and to explore the effect of glutamine on intestinal permeability and bacterial translocation.Methods: 80 patients with different types of intestinal obstruction were randomly divided into treatment group and control group.Control group received conventional treatment,including fasting,gastrointestinal decompression,correcting water electrolyte and acid-base balance disorders,total parenteral nutrition and antibiotics;treatment group used glutamine on the basis of conventional therapy.Peripheral blood of patients in the two groups were collected for Phthalocyanine amine plasma glutamate concentration and detection of bacterial DNA in whole blood,meanwhile,we measured urinary lactulose / mannitol(L/M) ratio,and statistical analysis was performed on the above indexes.Results: Serum albumin,serum prealbumin,serum transferrin in both groups increased higher significantly(P0.05) while blood glucose was obviously lower(P0.05).In the control group,IgA of the late course decreased sharply than the earlier(P0.05),but there was no significant change in the treatment group.Complications,infection rate,mortality,hospital stay and treatment costs in the treatment group were all lower than the control group(P0.05).Plasma glutamine concentrations in the treatment group was higher(P0.01) than the control group,but the urinary lactulose / mannitol(L/M) ratio in the late course and the positive rate of bacterial DNA in peripheral blood(P0.01).Conclusion: Glutamine plays an important role in maintaining gut barrier function in patients with intestinal obstruction,at the same time,it can reduce bacterial translocation and complications.