The effects of glutamine dipeptide and rhGH on improving endotoximea in sever burns

Objective To determine the effects of oral glutamine dipeptedeand recombinant human growth hormone (rhGH) on improving endotoximea in sever burns. Methods 36 sever burn patients were randomixed into control group,GLN group and GLN+rhGH group.The patients received enteral and parental nutrition after burn.All groups were isocaloric and isonitrogen.GLN group patients were biven oral glutamine dipeptide by a dose of 0.5g/kg/day(equivalent to L-glutamine 0.3mg/kg/day)from the 1st to 14th day after burn,GLN+rhGH group received glutamine dipeptede at the same dosage with GLN group and received rhGH from the 6th to 14th day post burn by a dose of 0.15IU.kg-1.d-1.At the day 1,14 post burn,the plasma amino acid was measured by a standard amino acid analyzer.At the day 1,3,6,14,the plasma Lps were detected with lymulus lysate assay,and then wound healing rate of burn area was determined at the ady 30 and the length of hospital stay was recorede. SPSS were used for data analysis. Results The plasma GLN concentration decreased in all patients at day 1 post burn(Control:325±36,GLN:289±21,GLN+rhGH:309±31 μm/L,normal value:659.5±35.0 μm/L),the GLN GROUP AND gln+rhGH group patients showed high plasma GLN concentration at day 14 (GLN:592±55,GLN+rhGH:603±29 μm/L),the difference between control group was significant.The plasma Lps concentration increased in all groups at day 1 post burn (Control:0.079±0.017,GLN:0.088±0.019,GLN+rhGH:0.086±0.012eu/ml,normal value:0.033eu/ml),the control group prolonged to the 14 days post burn (0.157±0.022eu/ml).The GLN group decreased in the 3rd day (0.047±0.010eu/ml)after burn and then increased from the 6th days (0.136±0.016eu/ml)to the 14th day (0.145±0.024eu/ml).The GLN+rhGH Lps concentration is lower than those of control group and GLN group ones at the 3rd,6th,14th day post burn (3rd day.0.043±0.012eu/ml,P=0.018,GLN+rhGH vs control;6th day:0.115±0.009,P=0.031,14th day.0.122±0.012eu/ml,P=0.024,GLN+rhGH vs GLN group).There were significant difference on wound healing rate at day 30 post burn (control group:72±8%,GLN group:86±5%,GLN+rhGH group:91±6%)and length of hospital stay (Control group:73±6days,GLN group:70±4days,GLN+rhGH group:66±7days). Conclusions The oral glutamine dipeptide combine rhGH could sustain the plasma glutamine level after severe burns,decrease the Lps level from early stage after burn,ameliorate wound healing rate at day 30,shorten the length of hospital stay.