岭南急诊医学杂志
嶺南急診醫學雜誌
령남급진의학잡지
LINGNAN JOURNAL OF EMERGENCY MEDICINE
2013年
1期
10-11,14
,共3页
张庆光%蒋凌志%刘干辉%钟华
張慶光%蔣凌誌%劉榦輝%鐘華
장경광%장릉지%류간휘%종화
谷氨酰胺%慢性阻塞性肺疾病%呼吸衰竭%免疫功能
穀氨酰胺%慢性阻塞性肺疾病%呼吸衰竭%免疫功能
곡안선알%만성조새성폐질병%호흡쇠갈%면역공능
Glutamine%chronic obstructive pulmonary disease%respiratory failure%immunologic function
目的：通过短期静脉应用丙氨酰－谷氨酰胺，探讨谷氨酰胺（Gln）对慢性阻塞性肺疾病（COPD）呼吸衰竭机械通气患者免疫功能的影响。方法：将40例COPD呼吸衰竭机械通气的患者随机分为干预组和非干预组各20例，两组均给予等热量、等氮静脉营养，干预组添加丙氨酰－谷氨酰胺，同时减少等量氮摄入，并选取COPD缓解期20例作为对照组，比较治疗前及治疗后第7 d 免疫学指标。结果：治疗前两组指标无显著差异，但与对照组比较，CD3＋、CD4＋、CD4＋/CD8＋、IgA 均显著下降；治疗后，干预组CD3＋、CD4＋、CD4＋/CD8＋以及 IgA、IgG 较治疗前均显著性增加（P ＜0．05）；治疗后两组组间比较有显著性差异（P ＜0．05）。结论：COPD 呼吸衰竭机械通气患者免疫功能明显下降，Gln可增强其免疫功能。
目的：通過短期靜脈應用丙氨酰－穀氨酰胺，探討穀氨酰胺（Gln）對慢性阻塞性肺疾病（COPD）呼吸衰竭機械通氣患者免疫功能的影響。方法：將40例COPD呼吸衰竭機械通氣的患者隨機分為榦預組和非榦預組各20例，兩組均給予等熱量、等氮靜脈營養，榦預組添加丙氨酰－穀氨酰胺，同時減少等量氮攝入，併選取COPD緩解期20例作為對照組，比較治療前及治療後第7 d 免疫學指標。結果：治療前兩組指標無顯著差異，但與對照組比較，CD3＋、CD4＋、CD4＋/CD8＋、IgA 均顯著下降；治療後，榦預組CD3＋、CD4＋、CD4＋/CD8＋以及 IgA、IgG 較治療前均顯著性增加（P ＜0．05）；治療後兩組組間比較有顯著性差異（P ＜0．05）。結論：COPD 呼吸衰竭機械通氣患者免疫功能明顯下降，Gln可增彊其免疫功能。
목적：통과단기정맥응용병안선－곡안선알，탐토곡안선알（Gln）대만성조새성폐질병（COPD）호흡쇠갈궤계통기환자면역공능적영향。방법：장40례COPD호흡쇠갈궤계통기적환자수궤분위간예조화비간예조각20례，량조균급여등열량、등담정맥영양，간예조첨가병안선－곡안선알，동시감소등량담섭입，병선취COPD완해기20례작위대조조，비교치료전급치료후제7 d 면역학지표。결과：치료전량조지표무현저차이，단여대조조비교，CD3＋、CD4＋、CD4＋/CD8＋、IgA 균현저하강；치료후，간예조CD3＋、CD4＋、CD4＋/CD8＋이급 IgA、IgG 교치료전균현저성증가（P ＜0．05）；치료후량조조간비교유현저성차이（P ＜0．05）。결론：COPD 호흡쇠갈궤계통기환자면역공능명현하강，Gln가증강기면역공능。
Objective: To evaluate the effect of glutamine on immune in chronic obstructive pulmonary disease (COPD) patients accompanied with respiratory failure. Methods: 40 patients with COPD accompanied with respiratory failure received mechanical ventilation therapy, were randomly divided into intervention group (n =20)and nonintervention group (n=20). Both groups were given parenteral nutrition,the total calory and nitrogen were equal. Intravenous Aln-Gln was supplemented to intervention group instead of equal protein. 20 remission COPD subjects were chosen as control group. The immune parameters were compared at pro-treatment and after treatment 7 days. Results: Before treatment, there was no significant difference in all immune indexes between the intervention group and nonintervention group. But CD3+、CD4+、CD4+/CD8+、IgA were significantly decreased (P<0.05) between control group and intervention group or nonintervention group. At the 7 days after therapy, CD3+,CD4+,CD4+/CD8+, IgA, IgG were significantly increased in intervention group. There was a significant difference between intervention group and nonintervention group (P<0.05). Conclusion: The immunologic function in COPD accompanied with respiratory failure patients decreased significantly, and Alanyl-Glutamine can improve immunologic functions in the cases.
