摘要
目的研究添加丙氨酰谷氨酰胺(Ala-Gln)的全胃肠外营养(TPN)对消化道肿瘤术后化疗老年患者的作用。方法30例消化道肿瘤老年患者,按序随机分为2组:传统组和二肽组,每组15例,术后给予TPN同时化疗5d。术前术后对人体测量、血浆蛋白、肝肾功能、血脂全套、血淋巴细胞数目等指标进行检测;术后监测每日氮平衡和累积氮平衡。结果二肽组上臂中部肌周长(AMC)、转铁蛋白(TRF)、血淋巴细胞数术后第6天能维持术前水平(P>0.05),传统组则明显低于术前(P<0.05);2组间人体测量、血浆蛋白、肝肾功能、血脂全套、淋巴细胞数差异无显著性(P>0.05)。术后第6天传统组累积氮平衡为(-32.17±10.16)g,二肽组为(-13.56±5.61)g,2组间差异显著(P<0.01)。结论老年消化道肿瘤患者术后化疗同时应用添加Ala-Gln的肠外营养是安全有效的,能减轻肿瘤患者术后的分解代谢,有效地改善机体氮平衡,维持血循环中淋巴细胞数目,增强对手术及化疗的耐受性。
Objective To study the effect of alanyl-glutamine （Ala-Gln） supplemented total parenteral nutrition （TPN） on old gastrointestinal cancer patients undergoing postoperative chemotherapy. Methods Thirty elderly patients receiving postoperative chemotherapy for 5 days were divided into two groups ： conventional TPN group （ control group） and Ala-Gln supplemented group （Ala-Gln group）. All patients received TPN, however,35% of nitrogen was supplied with Ala- Gin in Ala-Gln group. Anthropometric and biochemical parameters were monitored before and after the treatment. Resuits There were no significant differences between the two groups in anthropometric parameters, serum total protein （TP） , albumin （ ALB ） , prealbumin （ PAB ） , transferrin （ TRF ） , total lymphocyte count （ TLC ） , liver function, kidney function and serum lipid parameters. Compared with preoperative data, arm muscle circumference （AMC） , TRF and TLC remained unchanged at the end of the TPN in Ala-Gln group （ P 〉 0. 05 ） , but decreased significantly in control group （ P 〈 0. 05 ）. By the end of the study,cumulated nitrogen balance （CNB） in two groups was -32. 17 ±10. 16 g and - 13.56 ± 5.61g respectively. There were significant differences in nitrogen balance and CNB between the two groups （P 〈 0. 01 ）. Conclusions Ala-Gln supplemented TPN is safe and effective in the elderly patients undergoing postoperative chemotherapy. It attenuates protein catabolism, improving nitrogen balance, maintaining total lymphocyte count.
出处
《实用老年医学》
CAS
2008年第4期275-279,共5页
Practical Geriatrics
