谷氨酰胺和生长激素强化营养治疗对AECOPD患者营养和免疫状态的影响

Effects of intensified nutrition of glutamine and recombined human growth hormone on nutritional status and immune function in patients with acute exacerbation of chronic obstructive pulmonary disease

目的研究谷氨酰胺和重组人生长激素强化营养治疗对慢性阻塞性肺疾病急性加重期(AECOPD)患者的营养、免疫状态的影响。方法 60例AECOPD患者随机分为3组,A组给予标准营养支持治疗,B组加用谷氨酰胺,C组联用谷氨酰胺和重组人生长激素。治疗前及治疗后10 d测定血红蛋白(HGB)、血清总蛋白(TP)、血清白蛋白(ALB)、血清球蛋白(GLB)、前白蛋白(PAB)、淋巴细胞计数(LY)、T淋巴细胞亚群分析。结果营养支持治疗后B、C组患者TP、GLB、PAB较前升高;与A组相比,B、C组治疗后TP、ALB、GLB及B组PAB均升高;B、C两组比较,C组在治疗后ALB、PAB水平高于B组。3组患者治疗前后LY均较前升高;B、C组CD3+细胞比例及C组CD4+细胞比例较治疗前升高;C组患者LY及CD3+、CD4+、CD4+/CD8+均高于A组;B、C两组间,C组患者治疗后CD3+、CD4+细胞比例较B组高。结论谷氨酰胺和生长激素强化营养治疗可改善AECOPD患者营养状态及免疫功能。

Objective To evaluate the effects of the intensified nutrition of glutamine（Gln） and recombined human growth hormone（rhGH） on nutritional status and immunity in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods 60 patients of AECOPD were enrolled and randomized into 3 groups： group A（standard nutrition）,group B（Gln group）,group C（Gln plus rhGH）.The variables of hemoglobin（HGB）,total protein（TP）,albumin（ALB）,globulin（GLB）,prealbumin（PAB）,total lymphocytes,CD3,CD4,CD8 CD＋4/CD＋8 were measured before treatment started and 11 days after treatment.Results After treatment,TP,GLB,and PAB were significantly higher than those before in group B and C;TP,ALB,and GLB in group B,C and PAB in group B were significantly higher than those in group A;group C had higher ALB and PAB than group B.The total lymphocytes number of all 3 groups were higher after treatment,the percentage of CD3 in group B,C and CD4 in group C were significantly improved by treatment,group C had higher LY,percentage of CD3,CD4,and the ratio of CD＋4/CD＋8,and patients in group C had higher percentage of CD3 and CD4 than group B after treatment（all P0.05）.Conclusions Glutamine together with recombined human growth hormone intensifying nutrition support can improve nutritional status and immune function in patients with AECOPD.