中文摘要：

目的探讨传统全胃肠外营养及添加丙氨酰谷氨酰胺（Ala—Gln）的TPN对肝移植后移植肝功能和结构的影响。方法将24例肝移植病人随机分为两组：不添加Ala-Gln的TPN组（TPN组），添加Ala—Gin的TPN组（Gln组）。术后第2天予以等热量（每千克体重104．6kJ）、等氮量（每千克体重0．16g）共7d。监测术后第2天、第9天肝功能指标；观察供肝再灌注后、术后第9天移植肝结构的变化。结果术后第9天Gln组与TPN组比较，APOB与CHE增高幅度大且差异有统计学意义（P〈0．05）；AST的降低幅度大且差异有统计学意义（P〈0．05）。Gln组移植肝细胞超微结构改善优于TPN组。结论肝移植后添加Ala-Gln的TPN比传统TPN有利于移植肝缺血再灌注损伤的恢复。

英文摘要：

Objective To investigate the influence of alanyl-glutamine （Ala-Gln）-supplemented total parenteral nutrition （TPN） support on functional and structural changes of liver graft after orthotopic liver transplantation. Methods Twenty-four patients receiving liver transplantation were randomized into 2 groups. Group A had no addition of Ala-Gln and group B had it. All the patients received isocaloric （104.6 kJkg-1d-1） and isonitrogenous （0.16 gkg-1d-1） TPN for 7 days beginning from the 2nd d. The liver functional indexes were determined on day 2 and 9 after the transplantation. The morphological changes of the liver graft were observed on day 9 after the transplantation. Results On day 9 after the transplantation, APOB and CHE were significantly higher while AST lower in group B than in group A （P〈0.05）. The ultrastructure of liver cells was better in group B than in group A. Conclusion The recovery of ischemia/perfusion injury of liver graft can be markedly improved by TPN with Ala-Gln.