丙胺酰-谷氨酰胺双肽对重症患者近期临床结局的影响-617例回顾性研究报告

Effect of alanyl-glutamine dlpeptide on the short.term outcomes of critically m patients： a retrospective study of 617 cases

目的评估丙胺酰-谷氨酰胺（Ala-Gln）双肽强化的肠外营养对成年重症患者近期临床结局的影响。方法应用回顾性队列研究方法，将2006年1月至2011年12月海南省人民医院重症医学科救治的接受过规范肠外营养的成年重症患者，根据是否接受过Ala-Gln双肽强化的肠外营养，分为治疗组与对照组。评价添加Ala-Gin双肽≥0．5g／（kg·d）、疗程≥5d的肠外营养对成年重症患者ICU停留时间、ICU内新发医院感染与多器官功能障碍综合征发生率以及ICU内病死率的影响。结果最终入组617例，其中对照组312例，治疗组305例。与对照组患者相比，添加Ah-Gh双肽组患者ICU停留时间明显缩短[（17．2±6．5）d比（16．1±5．3）d，P=0．011]，ICU内新发感染率（42．9％比33．1％，P=0．011）和多器官功能障碍综合征发生率（46．5％比38．0％，P=0．030）以及ICU内病死率（34．9％比25．9％，P=0．014）均显著降低。结论添加Ala-Gla双肽≥0．5g／（kg·d）、疗程≥5d的肠外营养能够改善成年重症患者近期临床结局。

Objective To explore the effects of alanyl-glutamine （Ala-Gln） dipeptide supplemented par- enteral nutrition （PN） on the short-term outcomes in critically ill adult patients. Methods In this retrospective study, we reviewed the clnieal data of critically ill adult patients who were treated by standard PN from January 2006 tc December 201 i. The length of stay in intensive care unit （ICU-LOS）, incidences of infections and multi- ple organ dysfunction syndrome （ MODS）, and mortality were compared between the group of Ala-Gln dipeptide supplemented PN （intervention group） and the group of PN without Ala-Gln dipeptide （control group）. Results Finially, 617 cases were enrolled in the study, including 312 cases in the control group and 305 cases in the inter- vention group. The ICU-LOS was significantly shorter in the intervention group than that in the control group [ （ 17.2 ± 6. 5 ） d vs. （ 16. 1± 5.3 ） d, P = 0. 011 ）. Compared with the control group, the incidences of infec- tion （42. 9% vs. 33.1%, P =0. 011 ） and MODS （46. 5% vs. 38.0%, P =0. 030） and the mortality （34. 9% vs. 25.9%, P =0. 014） in the intervention group patients were significantly lower. Conclusion Ala-Gln dipep- tide supplemented PN can improve the short-term outcomes of critically ill adult patients.