谷氨酰胺对COPD营养不良者细胞免疫功能的影响

Effect of Glutamine Cellular Immune Modification to Malnourished Patients with COPD

目的 研究和评价谷氨酰胺对慢性阻塞性肺病(chronic obstructive palmonany disease,COPD)营养不良者细胞免疫的影响。方法 对32例COPD营养不良患者进行营养支持治疗,总能量摄入为静息能量消耗(REE)的1.5倍。A组(14例)为谷氨酰胺治疗组,口服L-谷氨酰胺10g,3次/d,B组(18例)为对照组。结果 营养支持后A组肱三头肌皮褶厚度,前白蛋白等营养参数较B组明显改善。A组α-肿瘤坏死因子,CD8治疗后显著下降,白介素-2,NO,CD3,CD4,CD4/CD8较前显著上升,与B组比较有统计学意义。结论 谷氨酰胺对COPD营养不良患者不仅有辅助营养支持作用,并具有免疫增强和调理作用,达到强化营养支持的效果,从而改善预后,具有很好的临床应用价值。

Objective To evaluate the effect of glutamine cellular immune modification to malnourished patients with COPD. Methods 32 patients were divided randomly into 2 groups: 14 patients in group A and 18 patients in group B. It took ten days to have the nutritional support which total calorie was 1. 5 REE, while group A orally administered L-argi-nine 10g t. i. d. supplementarily, group B were control subjects. Results In contrast with group B, the nutritional parame-ters such as TSF,PALB improved, TNF-β, CD8 decreased and IL-2,NO,CD3,CD4,CD4/CD8 increased significantly in group A. Conclusion L-arginine is not only effective of nutritional support in COPD,but also improves patients' immune function significantly. It could enhance effects of nutritional support and improve prognosis.