丙氨酰谷氨酰胺辅助治疗脓毒症的临床效果

Clinical effect of alanyl glutamine in the adjuvant treatment of sepsis

目的 观察丙氨酰谷氨酰胺辅助治疗脓毒症的临床效果。方法 选取2019年4月—2020年3月赣州市人民医院收治的脓毒症患者160例为研究对象,按随机数字表法分为对照组和观察组,各80例。对照组给予常规对症治疗,观察组在对照组基础上给予丙氨酰谷氨酰胺注射液辅助治疗,2组均用药7 d。比较2组用药前与用药7 d后急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、炎性指标[C反应蛋白(CRP)、内毒素(ETX)、肝素结合蛋白(HBP)]、二胺氧化酶(DAO)、D-乳酸,机械通气时间、住院时间及不良反应。结果 用药7 d后,2组APACHEⅡ评分低于用药前,且观察组低于对照组(P<0.05或P<0.01);2组血清CRP、ETX、HBP水平低于用药前,且观察组低于对照组(P<0.01);2组血清DAO水平高于用药前,D-乳酸水平低于用药前,且观察组升高/降低幅度大于对照组(P<0.01)。观察组患者的机械通气时间、住院时间短于对照组(P<0.01)。观察组不良反应总发生率与对照组比较,差异无统计学意义(2.50%vs.8.75%,χ^(2)=1.884,P=0.170)。结论 丙氨酰谷氨酰胺辅助治疗脓毒症可有效减轻疾病严重程度,抑制炎性反应,改善肠道屏障功能,缩短患者住院时间,且安全性较高。

Objective To observe the clinical effect of alanyl glutamine in the adjuvant treatment of sepsis.Methods A total of 160 cases of sepsis patients admitted Ganzhou People′s Hospital from April 2019 to March 2020 were selected as the study object,and they were divided into the control group and the observation group according to the random number table method,80 cases in each group.Patinets in the control group were given conventional symptomatic treatment,and patients in the observation group were given alanyl glutamine injection for adjuvant treatment on the basis of the control group,and both groups were medicated for 7 days.APACHEⅡ score,inflammatory factors(CRP,ETX,HBP),DAO,D-lactate before and after 7 days of medication,mechanical ventilation time,length of hospital stay,and adverse reactions were compared between the two groups.Results After 7 days of medication,APACHEⅡ score of the two groups was lower than that before medication,and the observation group was lower than that of the control group(P<0.05 or P<0.01);Serum levels of CRP,ETX,HBP of the two groups were lower than those before medication,and the observation group were lower than those of the control group(P<0.01);Serum DAO level of the two groups was higher than that before medication,and serum D-lactate level was lower than that before medication,and degree of increase/decrease were greater than those of the control group(P<0.01).Mechanical ventilation time,length of hospital stay in the observation group were shorter than those of the control group(P<0.01).There was no significant difference of total incidence of adverse reactions between the observation group and the control group(2.50% vs.8.75%,χ^(2)=1.884,P=0.170).Conclusion The adjuvant treatment of alanyl glutamine for sepsis can effectively reduce the severity of the disease,inhibit the inflammatory reaction,improve the intestinal barrier function,and shorten length of hospital stay,and with higher safety.