谷氨酰胺对慢性阻塞性肺疾病并发呼吸衰竭无创机械通气撤机时间的影响

Effect of Glutamine on the Weaning Time of Noninvasive Mechanical Ventilation in COPD Patients with Respiratory Failure

【目的】探讨谷氨酰胺（Gin）营养支持治疗对慢性阻塞性肺疾病（COPD）并发呼吸衰竭需无创机械通气治疗患者营养水平和撤机时间的影响。【方法】将36例COPD并发呼吸衰竭患者随机分为两组，在其它治疗相同的情况下，治疗组在复方氨基酸中加入0．5g／kg Gln静滴，持续两周，对照组仅用复方氨基酸。治疗前后分别测定体质量指数及检查外周血淋巴细胞总数（TLC）、血清白蛋白（Alb）、血清总胆固醇（TC）、肿瘤坏死因子（TNF），抽取动脉血作血气分析检测，并观测撤机时间，进行统计分析比较。【结果】两周后，治疗组TLC、Alb、TC明显高于对照组，而TNF低于对照组，血气分析结果较对照组改善更明显，撒机时间明显缩短，且两组相比差异有显著性（P〈0．05）。【结论】在治疗cOPD并发呼吸衰竭患者时，营养支持中补充Gln，有助于提高患者营养水平，缩短机械通气时间，改善预后。

[Objective] To explore the effect of glutamine（Gln） nutrition support on nutrition status and the weaning time of noninvasive mechanical ventilation in chronic obstructive pulmonary disease（COPD） patients with respiratory failure. [Methods] A total of 36 COPD patients with respiratory failure were divided into two groups. On the basis of the same therapy, the treatment group received intravenous instillation with Gln 0.5g/kg in amine acid, while the control group received amino acid only. Body mass index was measured before and after treatment. Peripheral blood lymphocyte count（TLC）, serum albumin（Alb）, serum total cholesterol（TC） and tumor necrosis factor（TNF） were examined. Arterial blood was drawn for blood gas analysis. The weaning time was observed. The difference between two groups was compared. [：Results] After two weeks, TLC, Alb and TC in treatment group were obviously higher than those in control group, hut TNF in treatment group was lower than that in control group. The improvement of blood gas analysis results in treatment group was more significant than that in control group, and the weaning time was obviously shorten, and there was significant difference（ P 〈0.05）. [Conclusion] The supplement of Gln in nutrition support during the treatment of COPD patients with respiratory failure, and is helpful to improve the nutritional status, and shortens the time of noninvasive mechanical ventilation, and improve the prognosis.