谷氨酰胺强化营养支持对老年急性胆囊炎术后营养不良患者营养功能及免疫功能的影响

Effects of Glutamine-enriched Nutritional Support on Nutritional Function and Immune Function in Elderly Patients with Malnutrition after Acute Cholecystitis Surgery

目的探讨谷氨酰胺强化营养支持对老年急性胆囊炎术后营养不良患者营养功能及免疫功能的影响。方法选取2019年1月至2022年10月于鹰潭市人民医院就诊的急性胆囊炎患者82例,按照随机抽签法将其分为强化组(n=41)和对照组(n=41),其中对照组采用常规营养支持,强化组在对照组的基础上静脉注射谷氨酰胺强化营养支持,比较两组患者术后第1天和术后1周营养指标[转铁蛋白(TF)、前白蛋白(PA)、血清白蛋白(ALB)]水平,比较两组患者术后第1天和术后1周免疫球蛋白[免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)]水平变化,比较两组患者术后第1天和术后1周T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))水平变化。结果术后第1天,两组患者的TF、PA、ALB、IgA、IgM、IgG、CD3^(+)、CD4^(+)、CD8^(+)均差异无统计学意义(P>0.05),术后1周时,两组患者的TF、PA、ALB、IgA、IgM、IgG、CD3^(+)、CD4^(+)均较术后第1天时显著上升(P<0.05),且强化组显著高于对照组(P<0.05),两组患者的CD8^(+)均较术后第1天时显著下降(P<0.05),且强化组显著低于对照组(P<0.05)。结论老年急性胆囊炎术后营养不良患者采用谷氨酰胺强化营养支持可有效改善患者的营养指标和免疫功能,利于患者的术后恢复。

Objective To explore the effects of glutamine-enriched nutritional support on nutritional function and immune function in elderly patients with malnutrition after acute cholecystitis surgery.Methods 82 patients with acute cholecystitis admitted to Yingtan People's Hospital from January 2019 to October 2022 were selected and divided into enriched group(n=41)and control group(n=41)according to the random drawing method.The control group was given routine nutritional support while the enriched group was given with intravenous injection of glutamine-enriched nutritional support on the basis of the control group.The nutritional indicators[transferrin(TF),prealbumin(PA),serum albumin(ALB)],immunoglobulins[immunoglobulin A(IgA),immunoglobulin M(IgM),immunoglobulin G(IgG)]and levels of T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+))were compared between the two groups on the 1st day after surgery and at 1 week after surgery.Results On the 1st day after surgery,there were no significant differences in TF,PA,ALB,IgA,IgM,IgG,CD3^(+),CD4^(+)and CD8^(+)between the two groups(P>0.05),the TF,PA,ALB,IgA,IgM,IgG,CD3^(+)and CD4^(+)in the two groups were significantly enhanced compared with those on the 1st day after surgery(P<0.05),and the above indicators in enriched group were significantly higher than those in control group(P<0.05).CD8^(+)in the two groups was significantly reduced compared with that on the 1st day after surgery(P<0.05).and the level was significantly lower in enriched group compared to control group(P<0.05).Conclusion Glutamineenriched nutritional support in elderly patients with malnutrition after acute cholecystitis surgery can effectively improve the nutritional indicators and immune function of patients.