谷氨酰胺对急性重症胰腺炎患者全胃肠外营养(TPN)的疗效观察

Effects of Glutamine-enriched Total Parenteral Nutrition on Severe Acute Pancreatitis

目的:探讨谷氨酰胺在急性重症胰腺炎(SAP)患者全胃肠外营养(TPN)中的疗效。方法:选择我院2009年7月-2011年6月间急性重症胰腺炎患者,随机分为治疗组(TPN+谷胺酰胺)和对照组(TPN),治疗7d后比较2组血清白蛋白、氮平衡及血清C反应蛋白的水平。结果:与对照组比较,治疗后治疗组血清白蛋白水平明显增高(P<0.05),负氮平衡的程度明显降低(P<0.05),血清C反应蛋白水平明显降低(P<0.05)。结论:在SAP患者TPN中,谷胺酰胺具有增加血清白蛋白合成、改善负氮平衡、减轻全身炎症反应等多方面的作用,值得在临床上推广。

Objective： To investigate the effects of total parenteral nutrition （TPN） with glutamine on patients with se- vere acute pancreatitis. Methods： Patients with severe pancreatitis were randomized equally into 2 groups and received standard TPN with intravenous infusion of glutamine（study group） or normal saline （control group） for 1 week. Serum levels of albumin,C-reactive protein and nitrogen balance was measured in these patients one day before and on day 8 of glutamine administration. Results; The study group exhibited a significant increase in serum albumin levels. Nitrogen balance also improved in the study group. The serum CRP levels were significantly decreased in the study group com- pared with the control group. Conclusion：The results suggest that treatment of TPN with glutamine may increase serum albumin level while improve nitrogen banlance, and alleviate inflammatory response compared with those who treated with nonenriched PN in severe acute pancreatitis.