谷氨酰胺对重症胰腺炎患者营养状况的影响

Effect of Glutamine on Nutrition State in Severe Acutc Pancreatitis

目的观察在重症胰腺炎(SAP)患者全胃肠外营养中应用N(2)-L-丙胺酸-L-谷氨酰胺(力太)对患者营养状况的影响。方法将41例SAP的患者随机分为常规全胃肠外营养(TPN)组(对照组)和加用力太的TPN组(谷氨酰胺组)。观察两组患者血清白蛋白水平,转铁蛋白水平以及体质量的变化并加以比较。结果两组患者入院时血清白蛋白分别为对照组(2 9.1±4.8 4)g/L,谷氨酰胺组(2 9.3±4.5 0)g/L,治疗2周后血清白蛋白水平分别为(29.5±4.62),(36.8±4.57)g/L,入院时对照组的体质量为(61.5±14.37)kg,谷氨酰胺组为(69.6±15.25)kg,治疗2周后分别为(57.1±14.63),(67.5±15.92)kg,入院时对照组转铁蛋白水平为(1.7±0.7)g/L,谷氨酰胺组为(1.7±0.4)g/L,治疗2周后分别为(1.3±0.1),(2.0±0.5)g/L,谷氨酰胺组与对照组均有显著的统计学差异(P<0.05)。结论在重症胰腺炎常规TPN治疗的基础上加用N(2)-L-丙胺酸-L-谷氨酰胺可以明显改善患者的营养状况,减少死亡率和并发症的发生率。

Objective To observe the effect of glutamine on nutrition, in severeacute ,pancreatits （SAP）. Methods Forty-one SAP patients was divided into two groups at random., there were 21 patients in routine TPN group and 20 ones in TPN ± glutamine grofip. The concentrations of serum albumin and transferrin, and body mass were observed. Results The concentrations of serum albumin in TPN group and TPN ± glutanine group were ,cspeclively （29.1 ± 4.84） g/L and （29, 3 ± 4.50） g/L at the beginning of hospitalization. After two weeks＇treatment, they became （29.5 ±4. 62） and （36.8 ±4.57）g/L. Body mass at the beging of hospitalization were （61.5 ± 14.37） kg and （69.6 ± 15.52） kg, After two weeks＇treatment they became （57. 1 ± 14. 63） and （67.5± 15.92） kg, respectively. The concentrations of treasferrin were（ 1.7 ±0. 7） g/L and （ 1.7 ±0. 4） g/L at first, and became （ 1. 3 ± 0.1 ） and （2.0 ± 0.5） g/L two weeks later. There were significantly statistical differences between the two groups in the concentrations of serum album and transferrin, and body mass. Conclusion Glutamine can improve the nutrition state of the patients with SAP in addition to TPN therapy. Also, it can reduce the mortality and morbidity of complications.