谷氨酰胺强化的低氮低热量肠外营养对结直肠癌合并慢性阻塞性肺疾病病人的影响

Impact of hypocaloric and hyponitrogenic parenteral nutrition supplemented with alanyl-glutamine on colorectal cancer patients with chronic obstructive pulmonary disease

目的:评价丙氨酰谷氨酰胺注射液(LALG)强化的低氮低热量肠外营养(PN)支持对合并慢性阻塞性肺疾病(COPD)的结直肠癌病人术后营养、免疫状况和肺功能的影响。方法:将48例符合研究标准的结直肠癌病人随机分为研究组和对照组,每组24例。所有病人均于术后使用非蛋白质热量83.7 kJ/(kg.d),氮为0.17g/(kg.d)的PN支持,研究组病人再加入LALG 0.5 g/(kg.d)。比较两组病人术后的营养指标、免疫功能、肺功能和肺部感染率。结果:术后第7天两组病人均转为氮平衡,营养和免疫功能指标均明显增高,但研究组增高更明显。研究组病人肺功能改善明显优于对照组,肺部感染率明显低于对照组。结论:加入LALG的低氮低热量PN可改善合并COPD的结直肠癌病人术后的营养状况,提高病人的免疫功能和肺功能,减少肺部感染的发生率。

Objective： To study the effect of hypocaloric and hyponitrogenic parenteral nutrition （PN） supplemented with L-alanyl-l-glutamine（LALG） on the postoperative nutrition, immune status and lung function of the colorectal cancer patients with chronic obstructive pulmonary disease （COPD）. Methods ： From July of 2007 to June of 2012, 48 colorectal cancer patients were randomly divided into study group （24 cases） and control group （24 cases）. All patients received hypocaloric[83.7 kJ/（kg · d） ] and hyponitrogenic [0.17 g/（ kg · d） ] PN from postoperation,and the study group received additional 0.5 g/（ kg· d）of LALG. The postoperative nutrition indicators, immune function indicators,lung function indicators and pulmonary infection rate were observed. Results： 7 days after operation, the two groups all turned from negative nitrogen balance to positive nitrogen balance. The nutrition and immune functions indicators increased significantly in two groups. The study group had better lung function than that the control group, and less lung infection rate. Conclusion： The hypocaloric and hyponitrogenic PN supplemented with LALG can improve the postoperative nutritional status, improve the immune function and lung function, decrease the lung infection in COPD patients with coloreetal carcinoma.