目的：探讨谷氨酰胺对急性放射性食管炎的临床疗效。方法将62例胸部恶性肿瘤放疗患者随机分成谷氨酰胺组（n＝31）和对照组（n＝31），2组均采用三维适形放疗。从放疗的第1天至放疗结束后2周，谷氨酰胺组在早、中、晚三餐餐后30 min 和睡觉前服用0．15 g·L－1谷氨酰胺25 mL；对照组服用生理盐水，用法用量同谷氨酰胺组。采用临床症状 RTOG 评分标准和内镜 Kuwaht’s 评分系统比较2组急性放射性食管炎的发生情况。结果临床症状RTOG 评分谷氨酰胺组2级及以上急性放射性食管炎发生率为22．58％，3级及以上急性放射性食管炎发生率为3．22％；对照组分别为61．29％、12．90％，对照组均显著高于谷氨酰胺组，差异具有统计学意义（P ＜0．05）。内镜 Kuwaht’s 评分谷氨酰胺组2级及以上急性放射性食管炎发生率为16．67％，对照组为55．56％，对照组显著高于谷氨酰胺组，差异具有统计学意义（P ＜0．05）。结论谷氨酰胺可减轻放疗对食管的毒性。%Objective To investigate the clinical effect of glutamine on acute radiation esoph-agitis.Methods Sixty-two patients undergoing radiotherapy for thoracic malignancies were ran-domized into two groups,with 31 patients in each group.All patients received three-dimensional conformal radiotherapy.From the first day of radiotherapy to two weeks after the end of radio-therapy,the glutamine group was given 25 mL glutamine (0.15 g·L-1 )30 minutes after meals and at bedtime,respectively.The control group received an equal amount of normal saline.The oc-currence of acute radiation esophagitis was evaluated using RTOG scoring system and Kuwaht’s criteria.Results According to RTOG scoring system,the grade 2 or worse acute esophagitis was observed in 22.58% of patients in glutamine group and 61.29% of patients in control group,and the grade 3 or worse acute esophagitis was observed in 3.22% of patients in glutamine group and 12.90% of patients in control group.According Kuwaht’s criteria,the grade 2 or worse acute esophagitis was observed in 16.67% of patients in glutamine group and 55.56% of patients in control group.The incidence of grade 2 or worse acute esophagitis in glutamine group was signifi-cantly lower than that in control group (P <0.05).Conclusion Glutamine can reduce the esopha-geal toxicity induced by radiotherapy.
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