高浓度支链氨基酸对直肠癌术后病人免疫状态和氮平衡的影响

目的:观察高浓度支链氨基酸用于直肠癌病人手术后对免疫功能及蛋白质代谢的影响. 方法:将40例手术治疗的直肠癌病人,随机分为研究组(高浓度支链氨基酸)和对照组 (复方氨基酸注射液),术后第1天开始使用,连续7 d.采用全营养混合液通过周围或中心静脉输注,均为等热量、等氮量.于手术前1 d、术后第1、4、7天抽静脉血,观察两组病人不同时期的免疫功能(CD4 、CD8 、CD4 /CD8 、IL-2R、IgG、IgM )、氮平衡、并发症及其他指标. 结果:两组病人入院时均有明显的免疫抑制,研究组CD4 、CD4 /CD8 、IL-2R在术后第4、7天与对照组相比有明显改善(P＜0.05).研究组与对照组均未出现严重的手术并发症.研究组于术后第4天转为正氮平衡,对照组第6天转为正氮平衡,两组间差异显著(P＜0.01). 结论:高浓度支链氨基酸能有效地改善直肠癌病人术后免疫状态和蛋白质代谢.     

高支链氨基酸在肝移植术后病人肠外营养中的应用

目的:评价肝移植术后病人以高支链氨基酸为氮源的静脉营养支持效果.方法:选择肝移植术后进行1周肠外营养支持(PN)的病人20例,随机分为高支链氨基酸组和平衡氨基酸组,每组各10例.两组营养支持均等热量、等氮量,分别于术后第1、8天检测营养状态指标.营养支持期间,每天测定氮,并计算累计氮平衡.结果:①两组病人体重、总蛋白、丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素、结合胆红素等肝功能指标均恢复较好.②术后第8天高支链氨基酸组血清清蛋白水平显著高于平衡氨基酸组(P＜0.05).③术后第3天起,高支链氨基酸组氮平衡明显优于平衡氨基酸组(P＜0.05).术后7d累计氮平衡高支链氨基酸组明显优于平衡氨基酸组(P＜0.01).结论:①肝移植术后采用高支链氨基酸作为氮源的静脉营养支持安全、有效.②高支链氨基酸的节氮效果优于平衡氨基酸.     

静脉输注氨基酸对严重创伤病人血氨基酸谱和氮平衡的影响

目的:探讨严重创伤病人静脉输注复方氨基酸对血游离氨基酸谱和氮平衡的的影响.方法:将40例严重创伤病人随机分为试验组(输注氨基酸+葡萄糖+脂肪乳剂)和对照组(输注葡萄糖+脂肪乳剂).4 d后测定血游离氨基酸谱和氮平衡. 结果:对照组病人大部分氨基酸(甘氨酸、半胱氨酸、缬氨酸、蛋氨酸、异亮氨酸、亮氨酸、赖氨酸、组氨酸、精氨...     

高支链氨基酸肠外营养支持对危重症病人肝肾功能保护作用的临床对照研究

目的:研究高支链氨基酸肠外营养(PN)液对危重症病人肝肾功能的支持和保护作用.方法:192例危重症病人为研究组,另172例危重症病人为对照组,对两组病人进行对照研究.两组病人PN时间均超过1周.研究组病人选用富含支链氨基酸的“复方氨基酸注射液(17AA-H)”;对照组选用均衡性“复方氨基酸注射液(18AA-Ⅱ)”,其他营养配置、用药和临床治疗无差别.比较两组病人PN前和PN后第1、3、5和7天的肝肾功能指标、APACHEⅡ评分等变化.结果:①PN治疗第3天后,两组病人总胆红素(TBIL)、谷丙转氨酶(AST)和谷草转氨酶(ALT)等均呈下降趋势;研究组治疗第7天TBIL水平显著低于对照组(P＜0.05).②PN治疗第3天后,仅研究组病人血清尿素氮(BUN)呈下降趋势,治疗第7天BUN水平显著低于对照组(P＜0.05).③PN治疗第3天后,两组病人APACHEⅡ评分均呈下降趋势,研究组显著低于对照组(P＜0.05).④PN治疗第7天后,研究组病人肝功能不全发生率由治疗前的28.6％降至19.8％,与治疗前比有显著性差异(P＜0.05).结论:富含支链氨基酸的PN液具有良好的肝肾器官保护作用,有利于病人康复.     

高支链氨基酸肠内营养对术后肝功能不全病人影响的临床观察

目的:观察高支链氨基酸肠内营养(EN)制剂对术后肝功能不全病人肝功能及营养代谢疗效和安全性. 方法:选择术后肝功不全伴低蛋白血症的病人50例,随机分为两组,观察组28例病人用高支链氨基酸EN制剂治疗,对照组22例病人用整蛋白全营养型EN支持治疗.分别于治疗第7和第14天,观察肝功能、营养状况的变化. 结果:两组病人营养支持治疗后的血清总蛋白、清蛋白、前清蛋白、转铁蛋白均显著高于EN支持治疗前(P＜0.01).观察组病人营养支持第14天前清蛋白显著高于对照组(P＜0.05).两组病人应用营养支持治疗后肝功能各项指标均有显著改善(P＜0.05). 结论:高支链氨基酸能有效地改善术后肝功能不全病人的营养状况和肝功能.     

添加1,6-二磷酸果糖的肠外营养在老年腹部手术病人中的应用

目的:探讨添加1,6-二磷酸果糖(FDP)的肠外营养在老年腹部手术病人中的应用价值.方法:将32例病人随机分成研究组和对照组,每组各16例.所有病人术后第1～6 d接受等热量83.6 kJ/(kg·d)和等氮0.2 g/(kg·d)的肠外营养.研究组不用甘油磷酸钠,手术当天开始每天用FDP 10 g.于术前和术后第1、7 d检测血浆清蛋白、前清蛋白、血磷,并做心电图.术后第1、3、5、7 d测尿3-甲基组氨酸(3-MH),并计算氮平衡.结果:两组病人手术前、后血磷平均值正常,术后血清清蛋白和前清蛋白值较术前均降低,对照组前清蛋白水平下降明显(P＜0.05).研究组术后尿3-MH排出较对照组明显减少(P＜0.05),术后累积氮平衡优于对照组(P＜0.05).结论:FDP具有补磷、肠外营养增效及维护心功能的作用,适合老年腹部手术病人.     

胃癌术后早期肠内免疫营养的作用

目的:研究肠内免疫营养对胃癌手术后病人营养、免疫及炎症反应的影响. 方法:将96例胃癌病人随机分为肠内免疫营养组(研究组)和常规肠内营养组(对照组),分别于术后第2～8天给予等氮、等热量的肠内营养支持.于手术前1天、术后第1天和第9天分别检测总蛋白、清蛋白、前清蛋白、转铁蛋白、IgG、IgM、IgA、CD4、CD8、CD4/CD8、IL-1α、IL-2、IL-6、IL-10、TNF-α等项目,用药期间留24 h尿、粪测定氮,计算氮平衡. 结果:研究结束时研究组前清蛋白、IgA、CD4、CD4/CD8均显著高于对照组,IL-6、TNF-α显著低于对照组. 结论:肠内免疫营养可减轻胃癌病人手术创伤后机体炎症反应,改善免疫功能.     

谷氨酰胺强化的低氮低热量肠外营养对结直肠癌合慢性阻塞性肺疾病病人的影响

目的:评价丙氨酰谷氨酰胺注射液(LALG)强化的低氮低热量肠外营养(PN)支持对合并慢性阻塞性肺疾病(COPD)的结直肠癌病人术后营养、免疫状况和肺功能的影响. 方法:将48例符合研究标准的结直肠癌病人随机分为研究组和对照组,每组24例.所有病人均于术后使用非蛋白质热量83.7 kJ/(kg·d),氮为0.17h/(kg·d)的PN支持,研究组病人再加入LALG 0.5g/(kg·d).比较两组病人术后的营养指标、免疫功能、肺功能和肺部感染率. 结果:术后第7天两组病人均转为氮平衡,营养和免疫功能指标均明显增高,但研究组增高更明显.研究组病人肺功能改善明显优于对照组,肺部感染率明显低于对照组. 结论:加入LALG的低氮低热量PN可改善合并COPD的结直肠癌病人术后的营养状况,提高病人的免疫功能和肺功能,减少肺部感染的发生率.     

肠内或肠外营养对手术后病人的氮平衡、肠通透性、血浆氨基酸及费用等的影响（60例随机、对照、多中心临床研究）

目的　观察肠内营养、肠外营养对手术后病人的的氮平衡、肠通透性、费用等影响。　对象和方法　随机、对照、多中心临床研究。 6 0例合乎计划要求的食道、胃、结肠道手术的患者为对象。按随机表进入研究组或对照组 ,两组为等氮等热卡营养摄入。研究计划经伦理委员会批准。所有病人均知情同意参加。　结果　 (1)安全性 :两组均无严重不良事件 ,对照组有 2例肝功损害 ,研究组无肝功损害 (P =0 .19)。 (2 )替代 (Surrogateefficacy)有效性指标 (Endpointmarkers) (1)氮平衡 :研究组累积氮平衡为 (10 8±10 7)mg·kg-1·6d-1,对照组累积氮平衡为 (94± 143)mg·kg-1·6d-1,两组无显著性差异 ,P =0 .6 75。 (2 )氨基酸谱 :两组血浆氨基酸的变化主要是谷氨酰胺 (GLN)在治疗前后的差值 (delta)有差异。研究组为 (-2 0 .1± 6 1.0 ) μmol/L ,对照组谷氨酰胺为 (- 10 6 .5± 79.2 ) μmol/L ,有显著性差异 ,P =0 .0 0 2。 (3)肠粘膜通透性结果 :两组在治疗前和治疗后 ,乳果糖 /甘露醇值差值 (delta)有不同。研究组增加 0 .0 2 0± 0 .0 12 ,对照组增加 0 .0 40± 0 .0 17,有显著性差异 ,P =0 .0 0 1。 (4)营养液药费 :研究组病人术后第三天至第九天的营养液药费明显低于对照组。研究组 :10 16± 110元 (人民币 )     

复方氨基酸注射液(17AA-H)在肝功能不全病人中的应用研究

目的:评价复方氨基酸注射液(17AA-H)对肝功能不全病人的营养支持效果及对肝功能恢复的影响. 方法:选择肝功能不全病人59例,给予肠外营养(PN)支持,采用回顾性非随机对照研究方法,根据氮源的不同分为两组.研究组29例使用复方氨基酸注射液(17AA-H),对照组30例使用复方氨基酸注射液(18AA-Ⅱ).比较两组病人PN前后营养指标(总蛋白、清蛋白)、肝功能指标(谷丙转氨酶、谷草转氨酶、总胆红素、直接胆红素、碱性磷酸酶、γ-谷氨酸转肽酶)等变化. 结果:两组病人PN支持后营养指标均有所改善,总蛋白、清蛋白组内比较有显著性差异(P＜0.05).研究组病人谷丙转氨酶、谷草转氨酶、总胆红素等有所恢复,前后比较有显著性差异(P＜0.05). 结论:使用17AA-H作为PN氮源,有助于改善肝功能不全病人的营养状况和肝功能恢复.     

支链氨基酸强化的肠内肠外营养对肝硬化大鼠术后肝功能及血浆氨基酸谱的影响

目的探讨支链氨基酸（BCAA）强化的早期肠内肠外营养支持对肝硬化大鼠肝部分切除术后肝功能及血浆氨基酸谱的影响,为临床合理应用提供实验依据。方法将24只雄性SD肝硬化大鼠按编号法随机分为肠内营养组、肠内营养＋BCAA组和肠外营养＋BCAA组3组,3组大鼠行肝部分切除术后1d分别进行等热量等氮量营养支持,共5d。术后6d测定大鼠体重、肝功能、前白蛋白、转铁蛋白、肝组织白蛋白mRNA的表达、Ki67蛋白表达指数及进行血浆氨基酸谱分析。结果与术前比较,术后肠内营养、肠内营养＋BCAA、肠外营养＋BCAA组大鼠体重均减轻（P〈0．05）。术后肠外营养＋BCAA组较肠内营养组碱性磷酸酶水平升高（P〈0．05）;肠外营养＋BCAA组较肠内营养＋BCAA组血清天冬氨酸氨基转移酶、丙氨酸氨基转移酶、碱性磷酸酶水平升高（P〈0．05）。术后肠外营养＋BCAA组较肠内营养、肠内营养＋BCAA组血清前白蛋白水平降低（P〈0．05）,转铁蛋白差异无统计学意义（P〉0．05）。肠外营养＋BCAA、肠内营养＋BCAA组较肠内营养组血浆中亮氨酸、异亮氨酸明显升高,酪氨酸、苯丙氨酸、精氨酸、色氨酸明显降低（P〈0．05）;肠外营养＋BCAA组与肠内营养＋BCAA组比较,各氨基酸浓度差异均无统计学意义（P〉0．05）。肠外营养＋BCAA、肠内营养＋BCAA组较肠内营养组总氨基酸及芳香族氨基酸均降低,BCAA及BCAA／芳香族氨基酸比值升高（P〈0．05）。肠外营养＋BCAA组较肠内营养、肠内营养＋BCAA组肝组织白蛋白mRNA表达水平及Ki67蛋白表达指数均降低（P〈0．05）。结论BCAA强化的肠内肠外营养支持能改善肝硬化大鼠血浆氨基酸失衡,恢复血浆中BCAA／芳香族氨基酸比值;肠内营养在改善肝功能、促进肝脏蛋白质合成和肝硬化大鼠肝切除术后残肝肝再生方面优于肠外营养,但仍不能提高血浆白蛋白水平。     

Metabolic effects of branched chain amino acids in patients with severe pancreatitis

Twenty-four patients with acute severe pancreatitis were randomised to receive total parenteral nutrition for 7 days with one of two isocaloric (35 kcal/kg/day) and isonitrogenous (0.16 g/kg/day) programmes containing either a low (15.5% w/w (control group)) or a high (57%) content of branched chain amino acids (BCAA (BCAA group)). During treatment, the nitrogen balance was similar in both groups. The concentrations of serum protein, albumin, prealbumin and retinol-binding protein did not differ between the groups. The plasma concentrations of BCAA measured 2 h after discontinuation of amino acid infusions rose in the BCAA group. In urine, only the concentrations of valine increased as compared with those of control patients. Serum glucose levels were higher in the BCAA group than in the control group, although the BCAA group received slightly more insulin than the control group in order to keep the blood glucose concentration below 10 mmol/l. The results suggest that BCAA-enriched solutions may stimulate gluconeogenesis without affecting catabolism.     

Branched-chain amino acids metabolic support in surgical patients: a randomized, controlled trial in patients with subtotal or total gastrectomy in 16 Japanese institutions

A prospective, randomized, controlled trial of nutritional effects of branched-chain-enriched amino acid (BCAA) solution was undertaken in 173 surgical patients with gastric cancer. Eighty-six and 87 patients underwent subtotal and total gastrectomy, respectively. The effects were evaluated in total parenteral nutrition (TPN) in an isocaloric/isonitrogenous setting where the major difference between the group was the amount of BCAA received. Each 80 patients in the control and the BCAA groups completed the trial. The group receiving BCAA-enriched amino acid solution demonstrated a statistically significant improvement on days 2 and 3 in nitrogen balance in patients with total gastrectomy. Three-methyl-histidine excretion gradually decreased after day 1, and the values on day 7 were significantly lower than those on day 1 in the BCAA group in both those receiving subtotal and total gastrectomy. There were no significant differences of serum albumin and rapid turnover proteins between the control and BCAA groups in both those receiving subtotal and total gastrectomy. Plasma BCAA level and BCAA to aromatic amino acid (AAA) ratio were significantly higher, and AAA level was significantly lower in the BCAA group than in the control group. There were no serious complications encountered during the observation period in both groups. These results indicated that a BCAA-enriched amino acid solution can improve metabolism and maintains good nitrogen retention without increasing side effects as compared with a conventional amino acid solution for nutritional support of patients who have received subtotal or total gastrectomy.     

Branched chain amino acid enriched parenteral nutrition in surgical intensive care patients

The metabolic responses to branched chain amino acid enriched total parenteral nutrition were studied in surgical intensive care patients with documented severe catabolism. Twenty-four patients were randomised to receive total parenteral nutrition with either 50% (BCAA) or 15% (Control) of its amino acid content as branched chain amino acids. The daily intake of nitrogen was 0.24 g per kg b. wt and that of energy, at steady state, 45 kcal per kg b. wt. Total parenteral nutrition resulted in similar nitrogen balances (Day 1 BCAA: -0.07 +/- 0.09, Control: -0.05 +/- 0.10; Day 4 BCAA: -0.12 +/- 0.07, Control: -0.06 +/- 0.09; Day 5 BCAA: -0.07 +/- 0.08, Control: -0.05 +/- 0.08 g/kg b. wt day; mean +/- S.D.) in both treatment groups throughout the study. The urinary excretion of 3-methylhistidine was higher before feeding in the control group but the rates were similar during total parenteral nutrition in both groups. There were no differences between the groups in the decrease of serum prealbumin during the study. We conclude that the proposed benefits, if any, from enriching nutritional regimens with branched chain amino acids are unlikely to be of major therapeutic relevance in severe catabolism.     

单能源与双能源全营养液对急性肝衰竭大鼠氮代谢影响的比较

目的　探讨含有高 BCAA的复方氨基酸、脂肪乳、糖、维生素、无机盐的混合营养液 (TNA)对急性肝衰竭大鼠氮代谢的影响。方法　应用 D-半乳糖胺腹腔注射诱导 Wistar大鼠呈急性肝脏衰竭。 72 h后随机分为富含 BCAA双能源 TNA组、富含 BCAA单能源 TNA组、普通饲料组、无氮饲料组观察其血浆总蛋白、白蛋白、前白蛋白、血浆氨基酸谱、氨平衡、肝肾功能的改变。结果　双能源组血浆氨基酸谱恢复接近正常 (P<0 .0 5)。普通饲料组、单能源组氨基酸谱恢复与无氮饲料组也有明显的差别 (P<0 .0 5)。双能源组血浆总蛋白、白蛋白、前白蛋白恢复较快。双能源组好于正常饲料组、单能源组 ,其中前白蛋白恢复更明显 (P<0 .0 5)。除无氮饲料组为负氮平衡 ,其余三组均为正氮平衡。肝功能 ALT、AST、ALP、Bil均以双能源组和普通饲料组恢复优于其他两组。肾功能以单能源组损害明显。结论　本研究设计的双能源 TNA对急性肝衰大鼠有较好的治疗效果 :提供了合理的能源底物 ,可改善血浆氨基酸谱至基本恢复正常 ,维持氮平衡 ,总蛋白、白蛋白明显回升。可能是葡萄糖、脂肪双能源 TNA供给的结构比例符合于肝衰竭代谢特点 ,促进了合成代谢 ,使损伤的肝细胞得以再生     

High-Branched Chain Amino Acid Solutions: Relationship of Composition to Efficacy

A prospective clinical trial was undertaken to determine the nitrogen-sparing efficacy of three amino acid solutions with different concentrations of branched-chain amino acids (BCAA) in 25 postoperative patients. The patients were a homogenous male population with stage I bladder cancer who underwent radical cystectomy. Administration rates of the intravenous solutions were designed to provide 30 kcal/kg/day and 1.5 g protein per kg per day during the 7-day study period. A control group (n = 4) received 5% dextrose in water (150 g/ day). Nitrogen balance was determined daily and the whole body protein turnover was measured using a primed-constant infusion of 15N glycine on postoperative days 3 and 4. The group receiving the 45% BCAA enriched (low leucine) amino acid solution exhibited a significant decrease in cumulative (7 day) nitrogen balance (7.6 ± 2.6 g) compared to the groups receiving either the standard 25% BCAA (19.9 ± 2.1 g) or the 45% BCAA enriched (high leucine) (21.6 ± 7.0 g) amino acid solution. The group receiving the 45% BCAA enriched (low leucine) amino acid solution exhibited a higher rate of mean whole body protein catabolism compared to the other groups. For patients undergoing major elective operations, the amount of leucine necessary for optimal daily nitrogen balance was 0.13 g/kg/day. These results demonstrate that the ratio of individual BCAA and the amount of leucine were more critical to nitrogen-sparing efficacy than the percentage total BCAA infused. (Journal of Parenteral and Enteral Nutrition 8:622–627, 1984)     

肝硬化大鼠肝部分切除术后肠外营养时氨基酸溶液的选择及评估

目的探讨肝硬化大鼠肝部分切除术后肠外营养时氨基酸溶液的选择及评估。方法6只正常大鼠作为正常对照组熏24只肝硬化大鼠随机分为肝硬化术前组、肝硬化肝部分切除术后1天组、肝部分切除术后行复方18种氨基酸溶液的肠外营养5天组、肝部分切除术后行富含支链氨基酸穴BCAA雪的氨基酸溶液的肠外营养5天组,每组6只。检测大鼠肝功能、血糖及血清生长激素穴GH雪、胰岛素样生长因子-1穴IGF-1雪、胰岛素样生长因子结合蛋白-3穴IGFBP-3雪,肝组织行Ki67免疫组化染色,结果判断计数采用Ki67指数。结果与复方18种氨基酸溶液的肠外营养比较,富含BCAA的氨基酸溶液的肠外营养5天后血清谷丙转氨酶穴ALT雪、碱性磷酸酶穴ALP雪水平降低熏GH水平也降低熏而IGF-1、IGFBP-3水平升高穴P<0.05雪熏但肝Ki67指数无显著性差异穴P>0.05雪。血清GH水平与谷草转氨酶穴AST雪、ALT、ALP呈正相关熏与白蛋白穴ALB雪呈负相关穴P<0.05雪熏而血清IGF-1、IGFBP-3水平与AST、ALT、ALP呈负相关熏与ALB呈正相关穴P<0.05雪。结论肝硬化肝部分切除术后肠外营养应选择富含BCAA的氨基酸溶液,检测血清GH、IGF-1、IGFBP-3有助于对营养素选择的评估。     

Nutritional support after liver transplantation: a randomized prospective study

Nutritional support in patients with advanced cirrhosis is difficult due to protein, fluid and salt restrictions. Successful liver transplantation should improve nutrient tolerance. We randomly assigned 28 hypoalbuminemic cirrhotic patients to receive, immediately after liver transplantation, one of three regimens: group 1, no nutritional support (n = 10); group 2, total parenteral nutrition (TPN) (35 kcal/kg/day) with standard amino acids (1.5 g/kg/day) (n = 8); or group 3, isocaloric isonitrogenous TPN with added branched-chain amino acids (n = 10). Therapy was continued for 7 days posttransplant. Jaundice resolution was unaffected by nutritional support. Nitrogen balance favored both TPN groups. Branched-chain amino acid (BCAA) aromatic amino acid ratios were highest in group 3. Coma scores and serum ammonia levels were similar in all groups. Both TPN groups achieved respirator independence earlier; this difference was not statistically significant. Group 1 patients stayed longest in ICU; the difference was statistically significant. TPN with either standard or BCAA- enriched amino acids is tolerated well immediately after successful liver transplant. Positive nitrogen balance is achieved; large protein loads do not worsen encephalopathy. Nutritional support may improve respiratory muscle function, allowing earlier weaning from ventilatory support. A shortened length of ICU stay justifies the expense of TPN.     

Nitrogen utilization during postoperative, low nitrogen, high caloric parenteral nutrition

Twenty elderly patients having undergone colonic resection were randomized into two regimens of postoperative parenteral nutrition. Fructoglucose satisfied the basal caloric needs of the patients. Amino acids were given as a mixture that provided 0.11 (0.09-0.14; mean and range) g/kg/day of nitrogen only. In half of the patients the energy intake was doubled with fat emulsion. The mean nitrogen-energy ratios in grams of nitrogen/kcal/day were 1:201 and 1:336 in the two groups, respectively. Both regimens were given for three days, starting from the first postoperative day. On the first day, the mean nitrogen balance was negative in both groups. On the third day, the mean balance was slightly positive in the amino acid, fructoglucose plus fat emulsion group, but negative in amino acid plus fructoglucose group. Amino acid concentrations in plasma and urine were markedly elevated in both groups, but relative concentrations in plasma remained rather normal. Apparently, a positive postoperative nitrogen balance can be obtained with restricted amino acid supply, if energy is provided in abundance.     

生长激素加早期肠内营养对高血压脑出血病人术后营养状况及并发症的影响

目的:探讨生长激素(GH)加早期肠内营养对高血压脑出血(HICH)病人术后营养状况及并发症的影响.方法:将122例高血压脑出血术后病人随机分成治疗组和对照组,每组61例.治疗组术后第2天开始肠内营养(EN)支持,同时每天联合应用GH,连用1周.对照组术后第2天开始胃肠外营养(TPN)支持.测定手术当天、术后第2天(营养支持第1天)和第3、7、14、21天的多项营养指标,并观察两组的临床疗效和并发症.结果:治疗组血清前清蛋白、转铁蛋白、清蛋白和氮平衡均明显高于对照组(P＜0.05);治疗组肺部感染、应激性溃疡和电解质紊乱发生率明显低于对照组(P＜0.05～0.01);治疗组平均入住ICU时间明显短于对照组(P＜0.05);治疗组第21天GCS评分＞8分的病人百分率明显高于对照组(P＜0.01).结论:生长激素联合早期肠内营养不仅可迅速改善高血压脑出血术后病人的营养状况、减少并发症,而且可缩短入住ICU时间,提高临床疗效.