丙氨酰谷氨酰胺加18AA复方氨基酸对肺结核并营养不良患者的营养状况改善效果评价

Treatment evaluation of N(2)-L-alanyl-L-glutamine and compound amino acid(18-AA) injection on malnutrition in patients with pulmonary tuberculosis

目的评价丙氨酰谷氨酰胺加18AA复方氨基酸对肺结核并营养不良患者营养支持治疗的临床效果。方法选择我科2012年1月～2014年6月住院肺结核合并营养不良患者86例，随机分为两组。治疗组在普通膳食基础上给予丙氨酰谷氨酰胺50mL：10g，加入18AA复方氨基酸注射液250mL：12．5g中静脉滴注，每日1次；对照组在普通膳食基础上仅给予葡萄糖等一般治疗。疗程4周。监测治疗前后两组患者的身高体重指数（BMI）、肱三头肌皮褶厚度（TSF）、上臂围（MAC）、血红蛋白（Hb）、血清白蛋白（ALB）、总淋巴细胞计数（TLC），比较治疗前后肺部病灶吸收有效率及痰菌转阴率。结果4周后治疗组BMI、Hb、ALB、TLC等明显上升，高于对照组，差异有统计学意义（P〈0．05）；肺部病灶吸收有效率明显高于对照组，差异有统计学意义（P〈0．05）；痰菌转阴率明显高于对照组，差异有统计学意义（P〈0．05）。结论丙氨酰谷氨酰胺加18AA复方氨基酸可明显改善肺结核患者的营养状况，提高临床疗效。促进肺结核患者康复。

Objective To study the clinical effect of N （2）-L-alanyl-L-glutamine and compound Amino Acid （18-AA） injection on malnutrition in patients with pulmonary tuberculosis. Methods A total of 86 hospitalized patients with pulmonary tuberculosis who were treated in our department from Jan 2012 to Jun 2014 were randomly divided into two groups. Treatment group（n=40） were received injection of N（2）-L-alanyl-L-giutamine 50 mL：10 g and compound Amino Acid （18-AA） 250 mL：12.5 g/d for 4 weeks on the basis of the average diet, while in comparison with control group （n=46） were given only general treatment with glucose injection. Monitor the index of the patients in two groups such as body mass index（BMI）,skinfold thickness of triceps（TSF）, mean arm muscle circumference（MAC）, hemoglobin （Hb）,serum albumin（ALB）, total lymphocyte count（TLC）,and the lung lesions absorption efficiency and sputum negative conversion rate before and after treatment were compared. Results 4 weeks later,the patients of treatment group witnessed an obvious rise in BMI, Hb, ALB, TLC, higher than control group with a statistically significant difference （P〈 0.05）;CT showed an efficient absorption of lung lesions higher than control group with a statistically significant difference（P〈0.05）; sputum examination showed a sputum negative conversion rate higher than control group with statistically significant difference（P〈0.05）. Conclusion Using N（2）-L-alanyl-L-glutamine and compound Amino Acid（18-AA） in- jection can improve the nutritional status of tuberculosis patients,improve clinical efficacy,and promote the rehabilitation of patients.