重症慢阻肺患者短期营养支持下血清氨基酸水平的变化

Change of serum free amino acid due to short-term nutritional support in patients with advanced chronic obstructive pulmonary disease

通过对25例重症慢阻肺(COPD)伴营养不良住院患者进行营养评价,并对其中12例患者进行短期静脉营养支持治疗(PN组),13例对照组患者仅给予抗感染、平喘、止咳等处理。以观察短期营养支持的效果及血清氨基酸水平的变化。结果显示:静脉营养支持可明显提高血清中某些氯基酸的水平及血清蛋白水平(P<0.05,P<0.01),改善患者的营养状况。但PN组治疗后尿素氮、尿肌酐及尿3-甲基组氨酸(3-MH)的排出并不比对照组下降明显,表明对此类患者进行静脉营养支持虽可促进机体蛋白质的合成,但并不能明显降低其蛋白质分解代谢率。

The nutritional status of 25 patients with ad- vanced chronic obstructive pulmonary disease (COPD) and accompanied malnutrition were as- sessed. All patients were randomly divided into parenteral nutrition (PN) group (12 cases) and con- trol group (13 cases).The PN group received 10% lntralipid and 5% Nutrisol S. Body weight, serum albumin, transferrin, prealbumin, fibronectin and se- rum free amion acid FAA were monitroed. The results showed that after 10～20 days＇PN support, the body weight, prealbumin, transferrin (P<0.05 or P<0.01 ) and some kinds of serum FAA were significantly in- creased. It is suggested that nutritional support may promote synthesis of protein in patients with malnutri- tion.but does ont obviously decrease the catabolic rate of protein.