谷氨酰胺强化肠外营养在外科危重患者中的作用

目的:探讨全胃肠外营养(TPN)加丙胺酰-谷氨酰胺注射液对外科危重症患者营养及免疫功能的影响。方法:将94例外科重症需要TPN的患者随机分为治疗组和对照组,均给予8dTPN治疗,其中治疗组患者每天加用丙胺酰-谷氨酰胺注射液0.4g/kg。检测患者TPN前、TPN后2d及8d的营养及免疫指标并进行分析。结果:治疗组、对照组与TPN前比较,TPN后2d血清ALB、PAB、TRF水平、PNI均有不同程度恢复,CD4的百分比、CD4/CD8比值、IgG、IgA、IgM有不同程度下降,治疗组优于对照组,在TPN后8d两组比较差异有统计学意义(t=2.235,t=2.167;P<0.05);而CD8的百分比与上述相反(t=2.178,P<0.01)。结论:外科危重症患者在TPN治疗基础上加用丙胺酰-谷氨酰胺注射液能有效改善机体营养和免疫状况,从而促进预后。

Effect on total parenteral nutrition supplemented with glutamine of critical patients in surgical

Objective： To explore the effect on alanyl glutamine added total parenteral nutrition （TPN） on patients＇ nutrition and immune function of critical patients in surgical. Methods： 94 patients were assigned into treatment group and control group randomly. All patients underwent TPN for 8 d. Injection of alanyl glutamine was given to the treatment group with a dose of 0.4 g/ kg. The level of nutrition index and immune index were determined and compared between preT~PN, 2 d and 8 d after TeN. Results： The level of ALB, PAB, TRF and PNi-of-both groups2-d after TPN were both decreased, the level of lgG, lgA, IgM, the percent of CD4, the ratio of CD4/CD8 both groups 2 d after TPN were all lower, the outcome of treatment group was better than control group, the difference on the level of above nutrition and immune data of two groups in day 8 is statistically significant （t=2.235, t=2.167; P〈0.05）.In contrast, the results in the percent of CD8 （t=2.17g, P〈0.01）increase. Conclusion： TPN added with alanyl glutamine is beneficial to critical patients in surcal, and ca improve patient＇s nutrition, enhance their immune function.