谷氨酰胺对急性期脑卒中营养状况恶化的预防作用

Preventing of parenteral glutamine peptide supplements from the deterioration of nutrition status following acute stroke

目的探讨谷氨酰胺对脑卒中急性期营养状况恶化以及卒中后神经功能康复的影响。方法收集临床住院脑卒中急性期病例86例,脑出血29例,脑梗死57例,谷氨酰胺组给予谷氨酰胺治疗,其余治疗内容与对照组相同;随后动态记录病程28d内营养状况的变化以及神经功能康复的程度,分析对照组与谷氨酰胺组在相同时间内营养状况的变化及神经功能康复的差异。结果(1)在相同的康复时间内,对照组营养状况的恶化程度明显较谷氨酰胺组严重。(2)谷氨酰胺组的神经功能缺损康复的程度明显好于对照组。结论(1)脑卒中急性期使用谷氨酰胺不仅具有改善卒中后营养状况恶化的作用,而且具有促进神经功能康复的作用。(2)谷氨酰胺可能通过增强机体的抵抗力,预防感染性并发症的发生,减轻营养状况的恶化,最终达到促进神经功能康复的效应。

Objective To study the prevention of glutamine peptide from the deterioration of nutrition status and the rehabilitation following acute stroke. Methods The study included 57 patients with cerebral ischemia and 29 patients with cerebral hemorrhage that were in less than 24 hours duration. Nutritional parameters were evaluated at admission and after 2 weeks following stroke respectively. Neurological deficit was also evaluated by the Chinese Stroke Scale at admission and after 28 days respectively. Results The degree of nutriture deteriorating was significantly severer in the contral group than the glutamine peptide group at the same duration following acute stroke. The extent of neurological deficit recovery was significantly lower in the control group than the glutamine peptide group. Conclusion 1. Parenteral glutamine supplements is helpful for the rehabilitation and preventing deterioration of nutrition status following acute stroke. 2. The effects of glutamine peptide on the rehabilitation of neurological deficit may be result from altering immune functions, preventing nutriture deterioration and infectious complication in secondary acute stroke.