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谷氨酰胺联合生长激素在肝移植病人术后应用的临床研究 被引量:5

The application of glutamine and growth hormone in patients undergoing liver transplantation
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摘要 目的:探讨谷氨酰胺(Gln)联合生长激素(GH)对肝移植术后病人的蛋白质合成、免疫功能、感染和急性排斥反应等的影响。方法:将60例肝移植病人前瞻性随机分为强化营养组(添加Gln+GH)和对照组。术后第2天开始,给予等热量83.68~104.6 kJ(20~25 kcal)/(kg.d)、等氮量0.16 g/(kg.d)的营养支持,共14 d。其中强化营养组给予丙氨酰谷氨酰胺双肽100 ml(20 g)/d和重组人生长激素(rhGH)9 U/d。同时监测病人术后第29、和16天的血清清蛋白(ALB)、前清蛋白(PA)、转铁蛋白(TF)、CD4/CD8值和观察各种预后指标。结果:强化营养组病人术后第9天PA和TF明显高于对照组(P<0.01),至术后第16天仍有显著性差异(P<0.05)。CD4/CD8亦较对照组明显升高(P<0.01)。强化营养组病人的感染发生率(13.3%)低于对照组(40.0%)。急性排斥反应的发生率两组比较无显著性差异。结论:肝移植术后病人添加Gln和GH的强化营养治疗,可增加蛋白质的合成,调节免疫功能,降低感染发生率,改善预后,并不增加急性排斥反应的发生率。 Objective: To explore the effects of glutamine(Gln) and growth hormone(GH) on the metabolism of protein,immunofunction,infection and acute rejection in patients undergoing liver transplantation.Methods: Sixty patients were prospectively randomized to study group enriched with Gln(alanyl-glutamine dipeptide 100 ml(20g)/day and GH(recombined human GH 9 U/day) or control group.All Patients received isocaloric 20-25 kcal/(kg·d) and isonitrogenous 0.16 g/(kg·d) nutrition after operation for 14 days.The serum levels of albumin(ALB),prealbumin(PA),transferrin(TF) and blood CD4/CD8 ratio were measured on the 2nd day,the 9th day and the 16th day after transplantation respectively.Results: PA and TF levels of the study group were significantly higher than the control group on the 9th day and the 16th day.CD4/CD8 ratio of the study group increased significantly.The incidence rate of infection(13.3%) of the study group was significantly lower than the control(40.0%),while the incidence rate of acute rejection had no significant difference between the two groups.Conclusion: The application of Gln and GH in patients undergoing liver transplantation can improve metabolism of protein,enhance the immunofunction,lower the incidence rate of infection and does not increase the incidence rate of acute rejection.
出处 《肠外与肠内营养》 CAS 北大核心 2011年第2期71-74,共4页 Parenteral & Enteral Nutrition
关键词 肝移植 谷氨酰胺 生长激素 免疫 感染 Liver transplantation Glutamine Growth hormone Immunofunction Infection
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