谷氨酰胺对危重患者免疫功能影响的随机对照研究

目的探讨危重患者补充谷氨酰胺(Gln)的肠外营养和标准肠外营养比较能否改善免疫功能。方法将60例外科危重患者随机分为实验组和对照组,每组30例,其中实验组由于Gln应用时间不够以及病情变化突然死亡等原因剔除5例。实验组给予强化Gln的全肠外营养支持,对照组为标准全肠外营养支持,两组等热等氮供给。检测治疗前、后血浆总蛋白、白蛋白、血红蛋白浓度,外周血IgA、IgG、IgM、总淋巴细胞数及T细胞亚群CD3、CD4百分率及CD4/CD8比值。结果实验组的总淋巴细胞数、IgG、CD4百分率和CD4/CD8比值均高于营养支持前及对照组(P<0.05)。结论强化Gln的肠外营养支持能改善外科危重患者机体的免疫功能,促进患者的康复,为危重患者有效的营养支持治疗提供临床研究依据。

Effect of Glutamine on Immune Function in Critically Patients: A Randomized Controlled Study

Objective To study the clinical effect of glutamine supplementation on critically patients. Methods Sixty critically patients were randomly divided into 2 groups. Thirty patients(5 patients were excluded for some reasons)were treated with total parenteral nutrition(TPN)by the administration of glutamine(experimental group). Thirty patients were treated with standard TPN(control group). Both two groups were supplied with equal nitrogen and calorics. Plasma levels of total protein, albumin, hemoglobin, parenteral plasma IgA, IgG, IgM concentrations and total lymphocyte counts, the percentage of T- lymphocyte subsets(CD3, CD4, CD8), the ratio of CD4 and CD8 were detected before and after treatment. Results T-lymphocyte, IgG, percentage of CD4 and the ratio of CD4/CD8 in experimental group were significantly higher than control group(P < 0.05). Conclusion TPN support with the admi- nistration of glutamine can improve the immune function of critically patients and promote their recovery.