丙氨酰谷氨酰胺对脓毒血症患者营养支持的临床研究

Analysis of nutritional support of acyl glutamine in patients with sepsis

目的探讨丙氨酰谷氨酰胺在脓毒血症患者中营养支持治疗的有效性。方法将46例脓毒血症患者随机分为观察组(23例)和对照组(23例)。对照组给予常规营养支持治疗,观察组在此基础上给予丙氨酰谷氨酰胺0.5 g/(Kg·d)加入3升静脉营养输液袋中和其它营养液混匀后经中心静脉匀速持续泵入,用药前及连续用药7天后检测两组患者血清前白蛋白(PA)、白蛋白(ALB)、转铁蛋白(TF)、免疫球蛋白A(Ig A)、免疫球蛋白M(Ig M)、免疫球蛋白G(Ig G)、超敏C反应蛋白(hs CRP)。结果在营养代谢方面,观察组PA、A LB、TF较对照组明显增高(P<0.05);在免疫功能方面,观察组Ig A、Ig M、Ig G较对照组明显增高(P<0.05);在炎症反应方面,观察组hs CRP较对照组明显下降(P<0.05)。结论脓毒血症患者在常规营养支持的基础上给予丙氨酰谷氨酰胺能够改善患者的营养代谢及提高机体免疫功能,同时还可以控制炎症反应,减少器官损伤,有利于改善患者的预后。

Objective： To explore the effectiveness of acyl glutamine in nutritional support for patients with sepsis. Methods： 46 cases of patient with sepsis were randomly divided into the observation group（ 23 cases） and control group（ 23 cases）. The patients in the control group received conversional nutritional support treatment,and the patients in the observation group received both routine nutritional support treatment and acyl glutamine of 0. 5 g / Kg d mixed with other nutrient solutions in intravenous nutrition infusion bag of three litres in the way of uniform and continuous pumping through central vein. PA,ALB,TF,Ig A,Ig M,Ig G and hs CRP of patients between two groups were detected before drug use and 7 days after continuous administration. Results： In terms of nutrition metabolism,PA,A LB and TF of patients in the observation group were significantly increased compared with those in the control group（ P〈0. 05）; in immune function,Ig A,Ig M and Ig G of the observation group were significantly increased compared with those in the control group（ P〈0. 05）; in inflammatory response,hs CRP of conservation group was significantly decreased compared with those in the control group（ P〈0. 05）. Conclusion： Conventional nutritional support combined with acyl glutamine can improve the nutrition metabolism and body＇s immune function,control inflammation response,reduce organ damage and improve the prognosis of patients with sepsis.