Influences of glutamine on liver function, C-reactive protein, lymphocyte count in the patients after hepatectomy with nutritional risk

Objective To evaluate the impact of glutamine nutritional support on liver function, immune function in postoperative patients after hepatectomy. Methods The clinical data of patients who have been subjected to the hepatectomy in general surgery of hospital of Guangzhou Military Command from January 2011 to December 2015 were continuously collected. The enrolled patients included those with NRS≥3, graded by NRS2002 scoring criteria. The liver function (AST, ALT, ALB, PAB, and CHE), C-reactive protein (CRP) and lymphocyte count (LY) were measured on the preoperative day and postoperative day 5, 7. The hospital stay and incidence of infectious complications were observed. Results 143 cases of patients in total were included in this study, and 84 cases were given glutamine treatment and 59 cases were not. The levels of ALT, ALB and PAB at postoperative day 7 were (54.5±38.0) U/L, (38.2±4.3) g/L and (175.7±17.6) mg/L respectively, which were significantly higher than (71.1±55.9) U/L, (34.6±5.2) g/L and (156.4±21.9) mg/L in the control group (t=-2.116, 4.503, 5.827, P=0.036, 0.019, 0.001). There was no significant difference in the levels of AST and CHE between the experimental group and the control group at postoperative day 7. The levels of CRP at postoperative day 7 were (32.4±15.4) mg/L, Which were significantly higher than (59.5±21.4) mg/L in the control group (t=-6.180, P=0.012). There was no significant difference in the levels of LY between the experimental group and the control group at postoperative day 7. There were 3 cases of infectious complication in the experimental group, and 7 cases in the control group, respectively (P=0.056). The hospital stay was (11.44±4.48) and (13.60±6.10) days in the experimental group and control group (t=-2.439, P=0.016). Conclusion Gln nutritional support can significantly improve liver function and immune function, reduce the incidence of infectious complication, and shorten the hospital stay for patients after hepatectomy. Key words: Glutamine; Hepatectomy; Nutritional risk; Liver function; Immune function