低剂量谷氨酰胺对老年脓毒症患者氧化应激保护作用的随机对照研究

The Effect of Low Dose Glutamine on Oxidative Stress in the Elderly with Se psis:a Randomized,Controlled Study

目的观察老年脓毒症危重期患者使用免疫营养添加物谷氨酰胺(Gln),对其营养状况和氧化应激损伤的影响。方法采用前瞻、随机、对照临床研究。28例老年脓毒症危重患者随机分为Gln强化营养组(n=14)和常规营养组(n=14),两组使用等热能肠内营养105kJ/(kg·d)。Gln组另给予Gln粉剂口服4g/d,连续7d,于第1、8天检测血清白蛋白(ALB)、前白蛋白(PAB)、脂质过氧化物(LPO)和谷胱甘肽(GSH)水平,并比较急性生理与慢性健康评分(APACHEⅡ)。结果Gln组第8天的血清PAB、GSH水平比常规组显著增高,差异有显著性(P<0.05),而血清LPO水平及APACHEⅡ评分均较常规组明显下降,两组差异有显著性(P<0.05)。结论老年脓毒症患者在危重期应用Gln强化的肠内营养可增进机体抗氧化应激的能力。

Objectives To investigate the effect of low dose glutamine(Gln)on oxidat iv e stress in the elderly with sepsis.Methods 28aged patients with sepsis were involved in a prospective,randomized and controlled trial.14aged sepsis pati ents were randomized to receive Gln powder orally4g/d for7days combined with g eneral enteral nutrition support105kJ/(kg·d)(Gln group),another14aged sepsis patients received general enteral nutrition105kJ/(kg·d)(control group).The levels of serum albumin(ALB),prealbumin(PAB),lipid peroxidate (LPO)and glutathione(GSH)were determined,and the scores of acute physiology and chronic health were evaluated(APACHEⅡ).Results Compared with Gln and co ntrol group at the eighth day,the levels of serum PAB and GSH in Gln group were significantly increased(P<0.05),while the level of serum LPO and score of APACHEⅡwere significantly decreased(P<0.05).Conclusions Low dose Gl n-intensified enteral nutrition support can increase the capacity of antioxidati ve stress in the elderly with sepsis.