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Clinical Analysis of Glutamine Powder in Preventing Neonatal Necrotizing Enterocolitis
- Aug 29, 2019 -

Necrotizing enterocolitis in neonates is a serious threat in neonatal period Infant life disorders are also the most common gastrointestinal emergencies in NICU. About 90% of them occur in premature infants. As the mortality of very low birth weight infants decreased, the incidence of NEC increased gradually.

Recent studies have shown that glutamine powder can significantly reduce the incidence of NEC. NEC is a serious intestinal acquired disease in neonatal period and one of the important causes of early death of neonates, especially premature infants. The main clinical manifestations of NEC are abdominal distention, vomiting, diarrhea, hematochezia, shock and multiple organ failure in severe cases. The abdominal X-ray examination is characterized by cystic pneumatosis in intestinal wall. The pathogenesis of NEC has been a research hotspot in recent years. Its pathogenesis is mainly related to the following factors: premature birth and low birth weight, genetic susceptibility, bacterial translocation, intestinal flora imbalance, infection, drugs, perinatal asphyxia, lack of essential or non-essential amino acids, etc. With the promotion of the policy of late childbearing and second birth, the increase of older and high-risk mothers and the development of assisted reproductive development technology, the incidence of premature infants, children with low birth weight and children with various perinatal acute and severe diseases is on the rise, along with the incidence of neonatal NEC is also on the rise.  At present, there is no unified standard and scheme for NEC prevention and control, and comprehensive measures are adopted to deal with the danger.

Risk factors should be prevented.

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In recent years, the role of glutamine powder deficiency in the pathogenesis of NEC has been widely recognized. Zhou Wei et al. found that prophylactic application of glutamine powder could improve the general condition of NEC neonatal rats, alleviate intestinal tissue damage, and promote intestinal mucosal damage in NEC neonatal rats.

Proliferative repair. Li Zhenghong and other studies have confirmed that glutamine powder supplementation has a positive impact on many aspects of premature infants, which can shorten parenteral nutrition and hospital stay, improve the tolerance of gastrointestinal feeding and reduce the incidence of infection. The results showed that glutamine powder supplementation could reduce the incidence of NEC in premature infants, shorten the time of enteral feeding and hospitalization, and achieve good average daily weight gain without adverse reactions.

glutamine powder is the most abundant conditional essential amino acid in human body. It is an energy-efficient substance. It provides nitrogen precursor for the synthesis of purine, pyrimidine and nucleotides in vivo, participates in the regulation of acid-base balance in vivo, transports nitrogen source, and is also the donor of nitrogen source. It is also the intestinal mucosal cells and various fast-acting substances.

Metabolic oxidative fuels of growth cells (such as renal tubular cells, lymphocytes, fibroblasts, macrophages) can promote the growth of intestinal epithelial cells and maintain the integrity of intestinal mucosal barrier. glutamine powder is mainly metabolized in the intestine, and the small intestine is the main organ that utilizes glutamine powder. Premature infants with immature gastrointestinal function are susceptible to severe gastrointestinal dysfunction caused by various factors such as infection, asphyxia and inappropriate feeding. At this time, glutamine powder storage in intestinal epithelial cells continues to decrease or even deplete. Supplementation of glutamine powder can stimulate the growth of gastrointestinal mucosa, promote the production of slgA, improve the functions of lymphocyte and phagocyte, improve cellular immunity and intestinal mucosal barrier function, thus reducing the incidence of NEC, reducing the severity of NEC disease, promoting the repair of intestinal mucosa, and facilitating the digestion and absorption of nutrients.

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