谷氨酰胺和生长激素对门静脉高压症患者术后营养、免疫和炎症反应的影响

Objective This study was conducted to evaluate the effects of postoperative glutamine and growth hormone on the nutritional status,immune function,and inflammatory responses of patients undergo-ing portal hypertension surgery.Methods This study was designed as a prospective,randomized and con-trolled clinical trial.Forty-two patients undergoing portal hypertension surgery were randomly divided into 2 groups:experimental group (receiving an immune enhancing parenteral nutrition by adding glutamine and re-combinant human growth hormone,n = 22),and control group (receiving an isocaloric and isonitrogenons standard parenteral nutrition,n = 20).Parenteral nutrition providing 125 kJ · kg-1·d-1 was initiated 3 days after surgery in both groups and last for 7 days.Blood samples were obtained on day 0th,3rd,and 10th.Host nutritional status was evaluated by measuring levels of prealbumin and transferrin,immunity was evalu-ated by measuring levels of CD4,CD8,CD4/CD8,IgG,IgM and IgA,and the inflanunatory responses was determined by assessing IL-2,TNF-α and C-reactive protein (CRP) levels.Results Ten days after opera-tion,among patients receiving an immune enhancing parenteral nutrition,the serum prealbumin was (193.84±39.78)mg/L,transferrin was (2.07±0.51)mg/L,CD4 was (33.7±5.5)%,CD4/CD8 was (1.17±0.32),IgG was (13.94±1.09)g/L and IL-2 was (368.12±59.25) pg/mL.They were signifi-cantly higher than those of the control group (P < 0.05).The TNF-α concentrations was (321.12±81.42)pg/mL and CRP was (32.2±15.2)mg/mL which were significantly lower than those of the control group (P < 0.05).Conclusion Postoperative administration of immune enhancing parentearl nutrition in patients undergoing portal hypertension surgery can improve nutritional status and immune function,and modulate inflammatory response is also better than standard one.

Effects of glutamine and growth hormone on nutritional status,immunity and inflammatory responses in postoperative patients with portal hypertension