丙氨酰谷氨酰胺围手术期应用对肝胆手术患者营养状况、免疫功能的影响

Effects of Perioperative Application of Alanyl Glutamine on Nutrition Status and Immune Function in Patients Undergoing Hepatobiliary Surgery

目的:探究丙氨酰谷氨酰胺(Ala-Gln)围手术期应用对肝胆手术患者营养状况、免疫功能的影响。方法:选取2018年1月至2018年12月收入我院的有营养风险的急性胆囊炎患者65例,随机分为两组,对照组(n=32)和观察组(n=33)。对照组给予常规全肠外营养支持,观察组在此基础上加入丙氨酰谷氨酰胺治疗。检测两组患者术后第2天和第9天的免疫球蛋白-A(IgA)、免疫球蛋白-M(IgM)、免疫球蛋白-G(IgG)、分化簇3(CD3)、分化簇4(CD4)/分化簇8(CD8)、转铁蛋白(TF)、前白蛋白(PA)、血清白蛋白(Alb);营养支持期间,统计并发症发生率。结果:术后第9天,观察组的IgA、IgM、IgG、CD3、CD4/CD8高于对照组(P<0.05);术后第9天,观察组PA、TF、Alb的浓度高于对照组(P<0.05);营养支持期间,观察组的并发症发生率低于对照组(P<0.05)。结论:在肝胆手术患者的围手术期,应用Ala-Gln能够改善患者营养状况、免疫功能,降低并发症的发生。

Objective: To explore effects of perioperative application of alanyl-glutamine(Ala-Gln)on nutrition status and immune function in patients undergoing hepatobiliary surgery. Methods: 65 patients with nutrition risk and acute cholecystitis who were admitted to the hospital from January 2018 to December 2018 were enrolled. They were randomly divided into control group(n=32)and observation group(n=33). The control group was given routine total parenteral nutrition support. On this basis, observation group was additionally treated with Ala-Gln. On the 2 nd and 9 th day after surgery, immunoglobulin-A(IgA), immunoglobulin-M(IgM), immunoglobulin-G(IgG), differentiation cluster 3(CD3), differentiation cluster 4(CD4)/differentiation cluster 8(CD8), transferrin(TF), prealbumin(PA)and serum albumin(Alb)in both groups were detected. The incidence of complications was statistically analyzed during nutrition support. Results: On the 9 th day after surgery, IgA, IgM, IgG, CD3 and CD4/CD8 in observation group were higher than those in control group(P<0.05). On the 9 th day after surgery, concentration of PA, TF and Alb in observation group was higher than that in control group(P<0.05). During nutrition support period, incidence of complications in observation group was lower than that in control group(P<0.05). Conclusion: In perioperative period of patients undergoing hepatobiliary surgery, Ala-Gln can improve their nutritional status and immune function, and reduce occurrence of complications.