中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2011年
2期
92-95
,共4页
吴国豪%张波%韩寓嵩%庄秋林%吴肇汉
吳國豪%張波%韓寓嵩%莊鞦林%吳肇漢
오국호%장파%한우숭%장추림%오조한
高支链氨基酸%肝功能损害%肠外营养
高支鏈氨基痠%肝功能損害%腸外營養
고지련안기산%간공능손해%장외영양
High branched-chain amino acids%Liver dysfunction%Parenteral nutrition
目的 探讨高支链氨基酸对肝功能受损外科患者的安全性和营养治疗作用.方法 前瞻性随机对照研究.复旦大学附属中山医院普外科2008年6月至2009年6月收治的82例梗阻性黄疸、肝硬化门静脉高压等肝功能损害手术患者.82例患者随机分为两组.两组给予为期1周的等热卡(25 kcal·kg-1·day-1)等氮(0.2 g·kg-1·day-1),肠外营养研究组42例使用高支链氨基酸注射液,对照组40例使用复方氨基酸注射液(15AA).研究期间检测两组的肝、肾功能、总胆固醇、三酸甘油酯、血糖、氮平衡和尿三甲基组氨酸浓度等.结果 两组病例不良事件发生率、人体测量值、生命体征、内脏蛋白浓度、血液学检查、肝肾功能、电解质、氮平衡、蛋白质分解代谢等方面无显著差异,研究组患者外周血免疫球蛋白、血淋巴细胞数回升较快,与照组比较差异有统计学意义(P＜0.05).结论 高支链氨基酸注射液是一种安全、有效的营养型氨基酸,对肝功能损害的外科患者术后肝功能和免疫系统的恢复切实有效.
目的 探討高支鏈氨基痠對肝功能受損外科患者的安全性和營養治療作用.方法 前瞻性隨機對照研究.複旦大學附屬中山醫院普外科2008年6月至2009年6月收治的82例梗阻性黃疸、肝硬化門靜脈高壓等肝功能損害手術患者.82例患者隨機分為兩組.兩組給予為期1週的等熱卡(25 kcal·kg-1·day-1)等氮(0.2 g·kg-1·day-1),腸外營養研究組42例使用高支鏈氨基痠註射液,對照組40例使用複方氨基痠註射液(15AA).研究期間檢測兩組的肝、腎功能、總膽固醇、三痠甘油酯、血糖、氮平衡和尿三甲基組氨痠濃度等.結果 兩組病例不良事件髮生率、人體測量值、生命體徵、內髒蛋白濃度、血液學檢查、肝腎功能、電解質、氮平衡、蛋白質分解代謝等方麵無顯著差異,研究組患者外週血免疫毬蛋白、血淋巴細胞數迴升較快,與照組比較差異有統計學意義(P＜0.05).結論 高支鏈氨基痠註射液是一種安全、有效的營養型氨基痠,對肝功能損害的外科患者術後肝功能和免疫繫統的恢複切實有效.
목적 탐토고지련안기산대간공능수손외과환자적안전성화영양치료작용.방법 전첨성수궤대조연구.복단대학부속중산의원보외과2008년6월지2009년6월수치적82례경조성황달、간경화문정맥고압등간공능손해수술환자.82례환자수궤분위량조.량조급여위기1주적등열잡(25 kcal·kg-1·day-1)등담(0.2 g·kg-1·day-1),장외영양연구조42례사용고지련안기산주사액,대조조40례사용복방안기산주사액(15AA).연구기간검측량조적간、신공능、총담고순、삼산감유지、혈당、담평형화뇨삼갑기조안산농도등.결과 량조병례불량사건발생솔、인체측량치、생명체정、내장단백농도、혈액학검사、간신공능、전해질、담평형、단백질분해대사등방면무현저차이,연구조환자외주혈면역구단백、혈림파세포수회승교쾌,여조조비교차이유통계학의의(P＜0.05).결론 고지련안기산주사액시일충안전、유효적영양형안기산,대간공능손해적외과환자술후간공능화면역계통적회복절실유효.
Objective To confirm the safety and nutritional efficacy of high branched-chain amino acids through a pragmatic study allowing its use as an alternative to 15AA in patients with liver dysfunction. Methods The study was performed as a randomized, prospective trial. Eighty two patients with liver dysfunction undergoing operation were randomly assigned to receive high branchedchain amino acids or 15AA as part of their TPN regimens for 7 days. Daily parenteral intakes of energy nitrogen and lipid were equal in the two groups. Results Efficacy analysis showed that high branched-chain amino acids were as efficient as 15AA in avoiding protein catablosim. No serious adverse event was reported in the two groups. For hematology, renal, hepatic safety criteria and for the vital signs,no significant difference was observed between the 2 groups. No significant difference was observed concerning nitrogen balance and protein catablosim. For peripheral immunoglobulin and lymphocytes, a statistically significant difference was observed between the high branched-chain amino acids and the 15AA groups. Conclusion High branched-chain amino acids is new, safe and efficient amino acids for parenteral nutrition.
