谷氨酰胺强化肠外营养对晚期恶性肿瘤患者免疫功能的影响

 目的　探讨强化L-丙氨酰-L-谷氨酰胺（LALG）的肠外营养对恶性肿瘤患者营养支持的应用价值。方法　将 68例恶性肿瘤患者按数字表法随机分为两组，每组34例，对照组单纯给予肠外营养，治疗组除给予肠外营养外，按每日0.3 g／kg补充LALG。分别测定在用药前和用药后第15天营养指标、免疫功能指标。结果　治疗组在肠外营养后前清蛋白（pALB）和转铁蛋白（TRF）水平比营养支持前明显上升[（24.9±8.06）mg／dl比（27.3±6.05）mg／dl；（1.62±0.43）g／L比（2.06±0.32）g／L]，差异有统计学意义（P＜0.05）。在治疗前，治疗组和对照组IgA、IgM、IgG差异无统计学意义（P＞0.05）；治疗组治疗后的IgA和IgG水平均高于治疗前[（2.85±1.43）mg／L比（3.63±5.36）mg／L；（0.95±0.43）mg／L比（1.13±0.09）mg／L]，差异有统计学意义（P＜0.05）；而对照组治疗前后IgA、IgM和IgG差异无统计学意义（P＞0.05）。治疗组治疗后的CD+4 值高于对照组[（39.19±4.23）%比（36.62±3.58）%]，差异有统计学意义（P＜0.05）；治疗组的CD+4／CD+8、CD+8值与对照组比较，差异无统计学意义（P＞0.05）。治疗组治疗后生活质量高于对照组（P＜0.05）。结论　LALG与单纯肠外营养联合比单纯的肠外营养更能明显改善晚期恶性肿瘤患者的营养状况、免疫功能。

Effects of L-alanyl-L-glutamine intensified parenteral nutrition support on immune of advanced malignant carcinoma patients

Objective　To evaluate the effects of L-alanyl-L-glutamine (LALG) intensified parenteral nutrition support in advanced malignant carcinoma patients. Methods　68 patients were randomly divided into two groups, control group (n = 34) received only parenteral nutrition, treatment group (n = 34) received parenteral nutrition combined with a dose of 0.3 g ?(kg?d)-1 LALG. Nutrition status and immune functions were determined at pre-therapy and 15th days after therapy. Results　After the therapy, the pALB and TRF of treatment group were significantly increased [(24.9±8.06) mg/dl vs (27.3±6.05) mg/dl; (1.62±0.43) g/L vs (2.06±0.32) g/L]. Before therapy, no significant change in IgA, IgM and IgG was found in two groups (P > 0.05). After the therapy, IgA and IgG of the treatment group after the therapy were significantly different from those before the therapy [(2.85±1.43) mg/L vs (3.63±5.36) mg/L; (0.95±0.43) mg/L vs (1.13±0.09) mg/L], IgA, IgM and IgG of the control group had no difference compared with those before the therapy (P > 0.05), CD+4 of treatment group was significantly different compared with those of control group [(39.19±4.23) % vs (36.62±3.58) %] (P < 0.05). There is no significantly difference between CD+4／CD+8, CD+8 of treatment group and those of control therapy (P > 0.05). After therapy, the score of quality of life in treatment group was higher than that in control group (P < 0.05). Conclusion　LALG intensified parenteral nutrition has better effects on improvement of the nutrition and immune functions.