The Protective Effects Of Glutamine Dipeptide On The Intestinal Mucosal Barrier In Patients Undergoing Cardiac Valve Replacement With Cardiopulmonary Bypass

Objectives: The function of the intestinal mucosal barrier depend on epithelium mucosae, enterokinesia, microbial population and endocritic of intestinal tract, and so on. The intestinal mucosal epithelial barrier plays a critical role. The previous studies have proven that gut is the central organ for surgical stress, and the intestinal mucosa is the most susceptible to ischemia/reperfusion leading to endotoxemia and finally functional impairment of the intestinal mucosal barrier. Endotoxemia(ETM) is closely related to the systemic inflammatory response syndrome(SIRS) and multiple organ dysfunction syndrome (MODS). During cardiopulmonary bypass (CPB), blood flow redistributes, abruptly reducing the blood flow to abdominal viscera. CPB may lead to intestinal ischemia-reperfusion injury and endotoxemia.To date, few researches on the influence of cardiopulmonary bypass on patients' intestinal mucosal barrier have been performed. In this study, patients undergoing cardiac valve replacement with cardiopulmonary bypass were divided into the control group and the Ala-Gln(Alanine-Glutamine)group, and the influence of cardiopulmonary bypass on the intestinal mucosal barrier as well as the protective effects of exogenous glutamine supplementation on it were preliminarily investigated.Methods:1. 40 eligible patients were randomized to the control group and the Ala-Gln group.2. Surgical procedures: Induction with Midazolam, Etomidate, and Vecuronium Bromide, tracheal intubation and balanced anesthesia were performed, with Fentanyl used for intraoperative maintenance. Jostra roller pump cardiopulmonary bypass unit (Germany), VITAL membrane oxygenator (USA) and the microembolus filtrator (Ningbo, China) were...