摘要
目的评价谷氨酰胺双肽对喉癌术后患者内毒素血症和免疫功能的影响。方法39例喉癌术后患者随机分为添加谷氨酰胺双肽的肠外营养组(Gln组,20例)和普通肠外营养组(PN组,19例),术后进行6天等氮、等热量的肠外营养支持。对血浆谷氨酰胺浓度、血浆内毒素水平、免疫球蛋白(Ig)和CD3、CD4、CD8、CD4/CD8,以及死亡率、感染有关并发症、住院费用和术后住院日等项目进行观察。结果Gln组术后6天血浆谷氨酰胺浓度为(598±63)μmol/L,显著高于PN组的(443±83)μmol/L(P<0·05)。两组术后1天内毒素水平均较术前升高,随时间逐渐下降,Gln组术后4天内毒素水平降低程度较PN组显著(P<0·05)。Gln组术后7天IgG和IgA,以及CD3、CD4和CD4/CD8均显著高于PN组(P<0·05)。本研究未出现死亡病例;两组均发生2例感染并发症;术后住院日和总住院费用两组相似。结论添加谷氨酰胺双肽的肠外营养能减轻喉癌术后患者的内毒素血症,改善免疫功能。
Objective To evaluate the effects of glutamine on plasma endotoxin level and immune function in postoperative patients with laryngeal carcinoma. Methods Thirty-nine patients following laryngectomy were randomly assigned to receive parenteral nutrition （PN） containing glutamine-bipeptide （Gln group, rt = 20） or general PN （PN group, n = 19）. The patients from two groups received isonitrogenous and isocaloric PN for 6 days after operation. Observed indicators included plasma glutamine concentration, plasma endotoxin level, immune function （IgG, IgA, IgM, CD3, CD4, CD8, CD4/CD8）, mortality, infectious complications, hospitalization cost, and hospital stay. Results The plasma glutamine level was （598 ± 63 ）μmol/L in Gln group on the 6th postoperative day, which was significantly higher than （ 443 ± 83 ）μmol/L in PN group （ P 〈 0.05 ）. The plasma endotoxin level obviously increased on the 1 st postoperative day and was significantly higher than preoperation; it decreased gradually, and the decrease was more significant in Gln group than in PN group on the 4th postoperative day （P 〈 0.05）. On the 7th postoperative day, the levels of IgG, IgA, CD3, CD4, and CD4/CD8 in Gln group were significantly higher than in PN group （P 〈 0.05）. There was no death case in this study.Two cases of infectious complications were reported in each group. The hospital stay and hospitalization expenses were similar between two groups. Conclusion The parenteral nutrition therapy with glutamine can decrease the endoxemia in postoperative patients with laryngeal carcinoma and improve their immune function.
出处
《中国临床营养杂志》
2006年第4期222-226,共5页
Chinese Journal of Clinical Nutrition
基金
国家人事部留学回国人员科研启动基金
关键词
谷氨酰胺
喉切除术
血内毒素
免疫功能
随机对照研究
glutamine
laryngectomy
plasma endotoxin
immune function
randomized controlled trial
