谷氨酰胺强化的营养支持对老年SIRS的调理作用

The efficacy of glutamine-intensified nutrition support on systemic inflammatory response syndrome in the elderly

目的 :观察谷氨酰胺 (Gln)强化的营养支持对老年全身炎症反应综合征 (SIRS)的免疫和急性炎症反应的调理作用。 方法 :采用随机对照方法 ,将 4 6例老年SIRS病人分为Gln组和对照组各 2 3例。Gln组给予Gln粉剂联合常规治疗 (热量 10 4 .6kJ/kg·d-1) ;对照组仅给予常规治疗 (热量同前 ) ,连续 7天 ,对照分析两组血清蛋白、免疫状态及病情严重度的变化。 结果 :①两组血清白蛋白、前白蛋白均无明显变化 (P >0 .0 5 ) ;②Gln组血清免疫球蛋白G(IgG)上升 ,C反应蛋白 (CRP)下降 ,与对照组比差异显著 (P <0 .0 5 ) ;③Gln组降低急性生理和慢性健康评分 (APACHEⅡ )优于对照组 (P <0 .0 5 )。 结论 :应用Gln增强的营养支持可改善老年SIRS病人免疫状态和急性炎症反应 ,有利于控制病情。

Objectives:To investigate the effect of glutamine(Gln) intensified nutrition support on host immune and acute inflammatory responses in the aged patients with systemic inflammatory response syndrome(SIRS). Methods:Forty six aged patients with SIRS were involved in a randomized controlled clinical trial,and divided into Gln group and control group.23 cases in Gln group were treated with intake of Gln power combined with routine treatment(energy intake of 104.6 kJ/kg·d -1 ),and another 23 cases in control group with routine treatment.All patients were observed for 7 days.The data about serum proteins,acute inflammatory responses and severity of illness were analysed. Results:①There were no significant differences in changes of the levels of serum albumin and preatbumin between 2 groups( P > 0.05 ).②The level of serum IgG increased in Gln group and maintained unchanged in control group.The level of serum CRP decreased more in Gln group than in control group( P <0.05).③The scores of acute physiology and chronic health evaluation(APACHE Ⅱ) decreased significantly in two groups( P < 0.05 ), and the decrease in Gln group was more obvious than in control group( P <0.05). Conclusions:Gln intensified nutrition support can improve the immune condition,control the acute inflammatory responses and relieve the illness in the aged patients with SIRS.