谷氨酰胺联合乌司他丁对严重烧伤患者营养状况及免疫功能的影响

Effects of glutamine combined with ulinastatin on nutrition state and immune function in severe burned patients

目的观察谷氨酰胺联合乌司他丁对严重烧伤患者营养状况及免疫功能的影响。方法将60例严重烧伤患者随机分为对照组和谷氨酰胺联合乌司他丁观察组,两组均给予等氮、等热量的全胃肠外营养(TPN)10 d,观察组氨基酸中0.5 g/kg由谷氨酰胺提供,同时静脉注射乌司他丁1周。检测治疗前1 d及治疗后10 d的氮平衡、血清白蛋白、前白蛋白、转铁蛋白I、gGI、gAI、gM、CD4、CD8和CD4/CD8。结果治疗后10 d观察组氮平衡、前白蛋白、转铁蛋白I、gGI、gAI、gM、CD4、和CD4/CD8显著高于治疗前1 d(P<0.05,P<0.01),与对照组比较差异有显著性(P<0.05,P<0.01)。结论联合使用谷氨酰胺及乌司他丁较单纯营养支持更能有效地改善烧伤患者的营养状况、提高患者的免疫力。

Objective To study the effects of glutamine combined with ulinastatin on nutrition state and immune function of patients with severe burn injury. Methods Sixty patients with severe burns were randomly divided into control group and treatment group.All patients received equal nitrogen and calorie for ten days.Patients in the treatment group were additionally supplemented with glutamine（0.5 g/kg） and ulinastatin for one week.Blood samples were obtained for measurement of nitrogen balance,ALB,P-ALB,TRP,IgG,IgA,IgM,CD4,CD8 and CD4/CD8. Results Ten days after treatment,significant increase of nitrogen balance,ALB,P-ALB,TRP,IgG,IgA,IgM,CD4,CD8 and CD4/CD8 were observed in treatment group,compared with those before treatment.Meanwhile,significant differences were found between the 2 groups in those parameters. Conclusion Glutamine combined with ulinastatin treatment may improve nutrition state and immune function in severe burn patients better than routine TPN.