丙胺酰-谷氨酰胺对外科危重症患者免疫功能的提高作用

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免疫功能的影响。方法将94例外科重症需要TPN的患者随机均分为治疗组和对照组,均给予8 d TPN治疗,其中治疗组患者每天加用丙胺酰-谷氨酰胺注射液0.4 g/kg。检测患者TPN前、TPN后2 d及8 d的CD4+、CD8+的百分比,CD4+/CD8+,IgG,IgA,IgM。结果与TPN前比较,两组TPN后2 d CD4+的百分比,CD4+/CD8+比值,IgG,IgA,IgM均有不同程度下降,且治疗组优于对照组;在TPN后8 d CD4+的百分比、CD4+/CD8+两组比较差异有统计学意义(P<0.05);而CD8+的百分比下降,与上述趋势相反(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免疫状况,促进预后。

Effect of Alanyl Glutamine Glutamine on Increasing Immunological Function in Surgical Critical Patients

Objective To explore the effect of alanyl glutamine added to the total parenteral nutrition （TPN） on the immune function in the surgical critical patients. Methods 94 surgical critical patients needing TPN were divided into the treatment group and the control group randomly and equally. All patients underwent TPN for 8 d. The treatment group was added with Alanyl Glutamine Injection 0. 4 g/kg. The indexes of cellular immunity and humoral immunity before TPN and on 2, 8 d after TPN were determined and compared between the two groups. Results Compared with before TPN, the levels of IgG, IgA, IgM, the percent of CD4＋, the ratio of CD4＋/CD8＋ after 2 d TPN in both groups were all decreased to some extent, but the treatment group was better than the control group. The increase of CD4＋ percent and CD4＋/CD8＋ after 8 d TPN had statistical difference between the two groups （P〈 0.05）, while the decrease of CD8＋ percent was contrary to the above trend （P 〈 0. 01）. Conclusion On the base of TPN therapy in the surgical critical patients, adding Alanyl Glutamine Injection can effectively improve their immune function status and promote the prognosis