中国临床药理学杂志
中國臨床藥理學雜誌
중국림상약이학잡지
THE CHINESE JOURNAL OF CLINICAL PHARMACOLOGY
2015年
8期
618-620,634
,共4页
王松志%吴乐军%吴应虬%朱建友
王鬆誌%吳樂軍%吳應虬%硃建友
왕송지%오악군%오응규%주건우
谷氨酰胺%肠外营养%营养状况%免疫功能
穀氨酰胺%腸外營養%營養狀況%免疫功能
곡안선알%장외영양%영양상황%면역공능
glutamine%parenteral nutrition%nutritional status%immune function
目的：评价谷氨酰胺强化肠外营养对全身炎症反应综合征（ SIRS）患者术后营养状况的改善及炎性反应的影响。方法入选SIRS患者40例并随机分为试验组和对照组，各20例。患者每日所需热卡量按20 kcal? kg-1，用糖、脂双能源供能方法；试验组的氮量由20％ L -丙氨酰-L -谷氨酰胺溶液供给（0.5 g? kg-1? d-1），其余部分用7％～11.4％氨基酸溶液供给，对照组的氮量仅用7％～11.4％氨基酸溶液供给。2组疗程均持续1周。比较2组患者肠外营养前后的血红蛋白、白蛋白、转铁蛋白及免疫球蛋白（ IgG、IgA和IgM）水平，并记录肠外营养后2组患者的营养风险筛查评分和急性生理与慢性健康评分。结果营养支持后，试验组患者血红蛋白、白蛋白和转铁蛋白水平分别为（116.5±9.2），（35.7±2.4）和（66.3±2.4）g? L-1，对照组分别为（102.5±8.6），（30.8±2.2）和（59.6±2.1）g? L-1，试验组显著高于对照组（P＜0.05）；试验组患者IgG、IgA和IgM水平明显高于对照组，且营养风险筛查评分和急性生理与慢性健康评分显著低于对照组（P＜0.05）。结论谷氨酰胺强化肠外营养对SIRS患者效果显著，可改善患者的营养状况，并有利于其免疫功能的恢复。
目的：評價穀氨酰胺彊化腸外營養對全身炎癥反應綜閤徵（ SIRS）患者術後營養狀況的改善及炎性反應的影響。方法入選SIRS患者40例併隨機分為試驗組和對照組，各20例。患者每日所需熱卡量按20 kcal? kg-1，用糖、脂雙能源供能方法；試驗組的氮量由20％ L -丙氨酰-L -穀氨酰胺溶液供給（0.5 g? kg-1? d-1），其餘部分用7％～11.4％氨基痠溶液供給，對照組的氮量僅用7％～11.4％氨基痠溶液供給。2組療程均持續1週。比較2組患者腸外營養前後的血紅蛋白、白蛋白、轉鐵蛋白及免疫毬蛋白（ IgG、IgA和IgM）水平，併記錄腸外營養後2組患者的營養風險篩查評分和急性生理與慢性健康評分。結果營養支持後，試驗組患者血紅蛋白、白蛋白和轉鐵蛋白水平分彆為（116.5±9.2），（35.7±2.4）和（66.3±2.4）g? L-1，對照組分彆為（102.5±8.6），（30.8±2.2）和（59.6±2.1）g? L-1，試驗組顯著高于對照組（P＜0.05）；試驗組患者IgG、IgA和IgM水平明顯高于對照組，且營養風險篩查評分和急性生理與慢性健康評分顯著低于對照組（P＜0.05）。結論穀氨酰胺彊化腸外營養對SIRS患者效果顯著，可改善患者的營養狀況，併有利于其免疫功能的恢複。
목적：평개곡안선알강화장외영양대전신염증반응종합정（ SIRS）환자술후영양상황적개선급염성반응적영향。방법입선SIRS환자40례병수궤분위시험조화대조조，각20례。환자매일소수열잡량안20 kcal? kg-1，용당、지쌍능원공능방법；시험조적담량유20％ L -병안선-L -곡안선알용액공급（0.5 g? kg-1? d-1），기여부분용7％～11.4％안기산용액공급，대조조적담량부용7％～11.4％안기산용액공급。2조료정균지속1주。비교2조환자장외영양전후적혈홍단백、백단백、전철단백급면역구단백（ IgG、IgA화IgM）수평，병기록장외영양후2조환자적영양풍험사사평분화급성생리여만성건강평분。결과영양지지후，시험조환자혈홍단백、백단백화전철단백수평분별위（116.5±9.2），（35.7±2.4）화（66.3±2.4）g? L-1，대조조분별위（102.5±8.6），（30.8±2.2）화（59.6±2.1）g? L-1，시험조현저고우대조조（P＜0.05）；시험조환자IgG、IgA화IgM수평명현고우대조조，차영양풍험사사평분화급성생리여만성건강평분현저저우대조조（P＜0.05）。결론곡안선알강화장외영양대SIRS환자효과현저，가개선환자적영양상황，병유리우기면역공능적회복。
Objective To explore the effect of glutamine on the nutritional status and inflammatory response by strengthening parenteral nutrition in patients after general surgery .Methods Forty patients with systemic inflammatory response syndrome ( SIRS ) in our hospital were selected , and all patients were randomly divided into treatment group and control group, with 20 cases in each group.Patients in treatment group were given glutamine to strengthen parenteral nutrition , while those in the control group received amino acid solution for parenteral nutrition .The treatment continued for one week .The data of level of hemoglobin , albu-min, transferrin and immunoglobulin (IgG, IgA, and IgM), as well as nutrition risk screening score and acute physiology , age and chronic health evaluation score in two groups before and after parenteral nutrition were recorded and compared .Results After parenteral nutrition , the data of hemoglobin ,albumin and transferrin in the treatment group were (116.5 ±9.2), (35.7 ±2.4) and (66.3 ±2.4) g? L-1, respective-ly, and (102.5 ±8.6), (30.8 ±2.2) and (59.6 ±2.1) g? L-1 in control group (P<0.05);after parenteral nutrition, the data of IgG, IgA, and IgM levels in the treatment group were significantly higher than those in the control group , and nutrition risk screening score and acute physiology and chronic health score were significantly lower than those in the control group (P <0.05).Conclusion The effect of glutamine parenteral nutrition on SIRS patients is significant , and it can im-prove patients′nutritional status and the immune function recovery .
