乌司他丁联合谷氨酰胺对严重烧伤患者营养及免疫功能的影响研究

Influence of Ulinastatin Combined with Glutamine on Nutrition State and Immune Function in Severe Burned Patients

目的:探讨乌司他丁联合谷氨酰胺对严重烧伤患者营养以及免疫功能的影响。方法:将我院住院治疗的80例严重烧伤患者随机分为对照组与观察组,两组患者均接受等氮等热卡的肠外营养,给予38例对照组患者同时口服甘氨酸为安慰剂,42例观察组接受乌司他丁联合谷氨酰胺联合治疗。比较两组患者住院期间创面脓毒症发生率、住院时间、创面愈合时间、血清谷氨酰胺浓度、血清白蛋白、转铁蛋白、免疫球蛋白、CD4、CD8水平。结果:观察组创面愈合时间、住院时间显著少于对照组(P<0.01);观察组与对照组住院期间创面脓毒症发生率分别为21.4%和57.9%,差别具有统计学意义(P<0.01);治疗后10d观察组血清谷氨酰胺浓度、血清白蛋白、转铁蛋白、IgG、IgM、CD4、CD4/CD8显著高于对照组(P<0.01)。结论:严重烧伤患者联合应用乌司他丁与谷氨酰胺,可显著提高谷氨酰胺水平,促进机体蛋白合成及创面愈合,减少并发症,缩短住院时间。

Objective： To explore the influence of ulinastatin combined with glutamine on nutrition state and immune function in severe burned patients. Method： 80 cases with severe burned patients were randomly divided into control group and observing group.All the patients received equal nitrogen and calorie parenteral nutrition.The patients in control group took glycin as placebo,while the patients in experience group received ulinastatin combined with glutamine treatment.The rate of sepsis,wound healing time,the time of hospital stay,serum level of glutamine,seralbumin,transferring,immunoglobulin,CD4 and CD8 were compared between two groups.Result： The wound healing time and hospital stay in observing group were much shorter than those in control group（P0.01）;The rate of sepsis was 21.4% and 57.9% in observing group and control group respectively（P0.01）;The serum level of glutamine,seralbumin,transferring,immunoglobulin,CD4 and CD4/CD8 in observing group were much higher than those in control group 10 days after treatment（P0.01）. Conclusion： Ulinastatin combined with glutamine for severe burned patients can greatly improve glutamine level,promote protein synthesis and wound healing,decrease complications and shorten hospital stay.