摘要
目的评价丙氨酸-谷氨酰胺(Ala-Gln)肠外营养对慢性阻塞性肺疾病(COPD)引起的呼吸衰竭患者营养治疗作用及免疫功能影响。方法22例COPD呼吸衰竭患者随机分为2组进行营养支持治疗,总能量摄入为基础能量消耗(BEE)的1．4倍。Ala-Gln组除给予鼻饲流质外,按1．5 mL·kg-1静脉补充Ala-Gln;对照组单纯给予鼻饲流质。在治疗前1d及治疗后d7、14、21测定氮平衡、营养指标、免疫功能指标及肝肾功能。结果Ala-Gln组前清蛋白(P-ALB),d 7达到(251±85)g·L-1,对照组为(222±69)g·L-1(P<0．05);白蛋白(ALB)、转铁蛋白(TRP)在治疗后d 21基本恢复正常,分别为(34．5±2．9)g·L-1、(2．34±0．37)g·L-1,对照组为(33．8±3．7)g·L-1、(2．21±0．48)g·L-1(P<0．05)。治疗前SIL-2R低于正常值,IL-6、IL-8高于正常值; Ala-Gln组治疗中SIL-2R升高,IL-6和IL-8降低,治疗后d 14分别为(31．2±5．1)pmol·L-1、(73．3±16．3)ng·L-1、(56．8±9．1) ng·L-1;对照组分别为(22．9±3．4)pmol·L-1、(86．4±13．6)ng·L-1、(64．7±8．6)ng·L-1(P<0．05),d 21接近正常值。2组治疗过程中无肝肾功能异常病例出现。结论肠外营养补充Ala-Gln对呼吸衰竭患者不仅辅助营养支持,并能调节细胞、体液免疫功能。
AIM To evaluate the effect of alanyl-glutamine （Aln-Gln） on nutrition and immune in patients with respiratory failure. METHODS Twenty-two patients with respiratory failure were randomly divided into 2 groups： Aln- Gln group and control group. Both groups were received standard enteral nutrition . Aln-Gln group as also supplemented intravenous Aln-Gln 1.5 mL·kg^-1. The nutritional, immune parameters,liver and kidney functions were measured before and 7,14, 21 d after treating. RESULTS At d 7, the serum prealbumin （P-ALB） level of Aln-Gln group improved to （251 ± 85） g·L^- 1, which was significant higher than that of control group（ P 〈 0.05）. Albumin （ALB） and transferring （TRP） of Aln-Gln group[ （34.5 ± 2.9）g·L^-1, （2.34 ± 0.37）g·L^-1 ]became normal at d 21, and were also higher than those of control group （ P 〈 0.05）. Before treating, SIL-2R was lower than normal level, and IL-6, IL-8 were higher than normal. Fourteen days after treating, in Aln-Gln group SIL-2R increased to （31.2 ± 5.1 ） pmol·L^-1 and IL-6, IL- 8 decreased to （73.3 ± 16.3）ng·mL^-1 ,（56.8±9.1）ng·mL^-1 respectively. The difference between Aln-Gln group and control group was significant（ P 〈 0.05）. SIL-2R, IL-6, IL-8 closed to normal at d 21 in Aln-Gln group. The liver and kidney functions of all the patients were normal during the test. CONCLUSION Alanyl-glutamine improves nutritional supporting and lymphocyte immune functions in patients with respiratory failure.
出处
《中国临床药学杂志》
CAS
2006年第3期182-184,共3页
Chinese Journal of Clinical Pharmacy
关键词
谷氨酰胺
呼吸衰竭
营养支持
细胞免疫
glutamine
respiratory failure
nutritional support
lymphocyte immune
