精氨酸对重度创伤患者术后恢复的影响

Effect of arginine on postoperative recovery of patients with severe trauma

目的探讨精氨酸对重度创伤患者术后恢复的影响。方法选取AIS-90创伤评分为16～25分的创伤患者37例,随机分为A组20例和B组17例。2组采用等氮等热量营养支持,A组患者未服用氨基酸,B组患者同时口服精氨酸10 g/次,3次/d,连用14 d。于术后第1,7,14天测定患者的血清总蛋白、白蛋白、体液免疫指标(IgG、IgA、IgM)、细胞免疫指标(CD3+、CD4+、CD8+和CD4+/CD8+)。结果 2组患者术后第1—14天,血清总蛋白、白蛋白和各种免疫指标(除CD8+降低外)均有改善,且B组患者增高程度更明显。结论精氨酸应用14 d似乎更能提高重度创伤患者血清总蛋白和白蛋白含量,改善患者免疫功能。

Objective It is to explore the effect of arginine on postoperative recovery of patients with severe trauma. Methods Thirty-seven cases of trauma patients whose trauma score were 16 to 25 points according to the AIS - 90 score were randomly divided into group A with 20 cases and group B with 17 cases. Both groups were given nutrition support of equal energy and nitrogen. Group A was not given amino acid and group was given arginine 10 g per time and 3 times per day by oral administration at the same time. The treatment lasted for 14 days. Serum total protein, albumin, humoral immune indicators （ IgG, lgA, and IgM） , cellular immune indicators （ CD3 ＋ , CD4 ＋ , CD8 ＋ and CD4 ＋/CD8 ＋ ） in the patients were determined in 1, 7, 14 days after operation. Results Serum total protein, albumin and every immune indieator（ except CD48 decreased） increased in both group from the first postoperative day to the fourteenth postoperative day, and the increase degree in group B was more obvious than that in group A. Conclusion The treatment with arginine for 14 days seems to increase the eontent of serum total protein and albumin and improve immune function more effectively in severe trauma patients.