添加丙氨酰-谷氨酰胺肠外营养在肝硬化门静脉高压患者术后的应用研究

The application of alanyl-glutamine parenteral nutrition in patients with cirrhotic portal hypertention after pericardial devascularization

选择肝硬化门静脉高压行断流术患者40例,随机均分为对照组和研究组。对照组术后1～7 d行常规肠外营养(PN),研究组在常规PN的基础上加用丙氨酰-谷氨酰胺(Ala-Gln)。检测两组术前及术后第1、3、5、7天营养状况、肝功能、免疫指标及术后并发症。结果显示两组患者体重、上臂围、蛋白质、T淋巴细胞亚群CD4+、CD8+、免疫球蛋白IgG、IgM和C反应蛋白差异有统计学意义(P<0.05)。肝硬化门静脉高压断流术后行添加Ala-Gln的PN较常规PN更有利于提高机体免疫力,改善营养状况,减轻炎症反应,减少术后并发症,其临床应用是安全有效的。

40 patients undergoing portal hypertention surgery were divided into control group （n = 20） and study group （ n = 20）. Control group received regular parenteral nutrition suppor from day 1 to day 7 after surgery. Study group received regular parenteral nutrition and alanyl-glutamine, Check the nutritional status., liver function, im- mune function, inflammatory responses on day 1, day 3, day 5, day 7 after the surgery and the complications. There were significant differences between the two groups in upper-arm circumference, weight, prealbumin, transferring, CD4 ＋ cells, CD8 ＋ cells, IgG, IgM and CRP（P 〈 0. 05） It proves that alanyl-glutamine parenteral nutrition in patients with cirrhotic portal hypertention after pericardial devascularization can improve the nutrition status and the immunity of the body. It also can relieve the inflammatory responses, reduce the complications and it is well tolerated, safe and available.