丙氨酰谷氨酰胺辅助治疗脓毒症效果分析

目的：研究丙氨酰谷氨酰胺对脓毒症的辅助治疗效果。方法以2010年8月至2013年2月清远市人民医院重症医学科（IC U ）收治的120脓毒症患者为研究对象，将其随机分为实验组和对照组，对照组采用常规治疗，实验组在常规治疗的基础上静脉滴注丙氨酰谷氨酰胺，剂量为0．4g/（kg·d），每日最大剂量为20g。比较两组患者治疗期间的胰岛素使用剂量、血糖水平、院内感染发生率、IC U住院时间、总住院时间及6月生存率。结果实验组与对照组胰岛素使用剂量分别为（3．8±3．1）、（4．5±3．5）IU/h ，血糖水平分别为（8．9±2．0）、（10．8±3．1）mol/L ，院内感染发生率分别为1．2‰及3．0‰，组间比较差异有统计学意义（P＜0．05）。但ICU住院时间、总住院时间、6月生存率组间比较差异无统计学意义（P＞0．05）。结论对于脓毒症患者，每日静脉滴注丙氨酰谷氨酰胺，可能有助于控制血糖水平、改善胰岛素抵抗、降低院内感染发生风险，但对患者预后无显著改善效果。

Application of alanyl glutamine for the treatment of sepsis

Objective To investigate the effects of alanyl glutamine for the treatment of sepsis .Methods Be-tween August 2010 and February 2013 ,120 sepsis patients ,treated in this hospital ,were randomly divided into con-trol group ,given routine treatment ,and experiment group ,given intravenous injection of alanyl glutamine ,with dosage of 0 .4 g/（kg· d） and upper volume of 20 g/d ,except routine treatment .Dosage of insulin treatment ,glucose level , incidence of hospital infection ,length of ICU stay ,total length of hospital stay and overall survival rate in 6 month was respectively compared between the groups .Results In experiment group and control group ,dosage of insulin treatment were （3 .8 ± 3 .1） and （4 .5 ± 3 .5）IU/h ,glucose levels were （8 .9 ± 2 .0） and （10 .8 ± 3 .1）mol/L ,incidence of hospital infection were 1 .2‰ and 3 .0‰ ,all of which were with statistical difference （P〈0 .05） ,but length of ICU stay ,total length of hospital stay and overall survival rate in 6 month were not significantly different （P〉0 .05） . Conclusion For patients with sepsis ,intravenous injection of alanyl glutamine could be helpful for controlling blood glucose level ,improving insulin resistance and reducing the risk of nosocomial infection .However ,treatment of alanyl glutamine might be not obvious efficient to improve the prognosis .