丙氨酰谷氨酰胺对老年肠梗阻急性炎症反应和免疫功能的影响

Study on effect of alanyl-glutamine on acute inflammatory response and immune function in elderly patients with intestinal obstruction

目的探讨丙氨酰谷氨酰胺对老年肠梗阻患者急性炎症反应和免疫功能的影响。方法老年肠梗阻患者45例,随机分为治疗组23例和对照组22例,对照组采用常规全肠外营养(TPN),治疗组在常规TPN基础上静脉应用丙氨酰谷氨酰胺[0.4 g/(kg.d)],治疗1周后检测两组患者血清白细胞介素(IL)-6及肿瘤坏死因子α(TNF-α)水平,血清T淋巴细胞亚群,血清免疫球蛋白IgA、IgG、IgM水平。结果治疗1周后,治疗组血清IL-6及TNF-α水平明显低于对照组(P<0.01),血清CD3、CD4和CD4/CD8明显高于对照组(P<0.05),血清IgG、IgA水平明显高于对照组(P<0.05)。结论丙氨酰谷氨酰胺可以减轻老年肠梗阻患者急性炎症反应,改善免疫功能。

Objective To explore the effect of alanyl-glutamine on acute inflammatory response and immune function in elderly patients with intestinal obstruction.Methods A total of 45 elderly patients with intestinal obstruction were randomly divided into control group and trial group.Patients in control group received conventional total parenteral nutrition（TPN）,patients in trial group received intravenous infusion of alanyl-glutamine 0.4 g/（kg.d） on the basis of conventional total parenteral nutrition.After treatment for one week,the serum levels of interleukin-6（IL-6） and tumor necrosis factor-alpha（TNF-α）,T-lymphocyte subsets and serum levels of immunoglobulin IgA,IgG and IgM were determined.Results The serum levels of IL-6 and TNF-α in patients of trial group after treatment for 1 week were significantly lower than those of control group（P 0.01）,serum CD3,CD4 and CD4/CD8 ratio in patients of trial group were significantly higher than those of control group（P 0.05）,and serum levels of immunoglobulin IgA,IgG and IgM in patients of trial group were significantly higher than those of patients in control group（P 0.05）.Conclusion Alanyl-glutamine can relieve acute inflammatory response and improve immune function in elderly patients with intestinal obstruction.