摘要
目的观察丙氨酰谷氨酰胺(Ala-Gln)对急性肺损伤(ALI)患者的保护作用及其机制。方法 110例ALI患者随机分为对照组(50例)和Ala-Gln组(60例)。对照组给予常规治疗,Ala-Gln组在常规治疗的基础上,加用Ala-Gln,疗程7天,分别观察两组间治疗前后血清谷氨酰胺(Gln)、热休克蛋白70(HSP70)水平、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)及机械通气时间的差异。结果 Ala-Gln组治疗后血清HSP70、Gln水平明显增高,与治疗前比较差异有统计学意义,HSP70(1.99±0.66)μg/L vs(1.34±0.68)μg/L(P<0.01);Gln(386.15±68.60)μg/L vs(304.72±73.70)μg/L(P<0.01)。与对照组治疗后比较差异亦有统计学意义,Gln(386.15±68.60)μg/Lvs(303.74±78.08)μg/L(P<0.01);HSP70(1.99±0.66)μg/L vs(1.35±0.48)μg/L(P<0.01)。Ala-Gln组治疗前后Gln浓度比与HSP70浓度比呈明显正相关(r=0.809,P<0.01),对照组治疗前后血清Gln、HSP70水平差异无统计学意义,对照组治疗前后Gln浓度比与HSP70浓度比无明显相关性(r=0.147,P>0.05)。Ala-Gln组机械通气时间明显低于对照组,(162.20±96.33)小时vs(235.00±107.90)小时(P<0.05)。治疗后APACHEⅡ评分的改善明显优于对照组,(8.40±2.17)分vs(11.10±2.42)分(P<0.05)。结论 Ala-Gln治疗可显著提高ALI患者血清Gln、HSP70水平、缩短机械通气时间,改善APACHEⅡ评分,提示Ala-Gln对ALI患者具有保护作用,其机制可能与提高患者体内Gln、HSP70水平有关。
Objective To investigate the protection effect and mechanism of alanyl-glutamine（Ala-Gln） during acute lung injury（ALI）.Methods 110 patients with ALI were randomly divided into two groups： control group（n=50） and Ala-Gln group（n=60）,Ala-Gln group received intravenous infusion Ala-Gln in addition to conventional treatment for 7 days,and control group only received conventional treatment,the levels of glutamine（Gln）,heat shock 70 kDa protein（HSP-70） in serums of ALI patients and score of APACHEⅡ pre-and post-treatment were compared respectively,and the duration of mechnical ventilation between the two groups was also compared.Results The post-treatment levels of Gln and HSP-70 of Ala-Gln group were statistically higher than pre-treatment levels in the same group and post-treatment levels of control group（P0.01）,Gln of Ala-Gln group：（386.15±68.60） μg/L vs（304.72±73.70） μg/L（P0.01）;HSP70 of Ala-Gln group：（1.99±0.66） μg/L vs（1.34±0.68） μg/L（P0.01）.Gln of two groups in post-treatment：（303.74±78.08） μg/L vs（386.15±68.60） μg/L（P0.01）;HSP70 of two groups in post-treatment：（1.99±0.66） μg/L vs（1.35±0.48） μg/L（P0.01）.Gln concentration ratio of pre-and post treatment was positively correlated with HSP70 concentration ratio of pre-and post treatment（r=0.809,P0.01）;There was no significant difference between the pre-and post-treatment levels of Gln and HSP-70 of control group,and there was no significant correlation between Gln concentration ratio and HSP-70 concentration ratio of pre-and post treatment of control group.The duration of mechnical ventilation and the score of APACHEⅡ of two groups had significant differences,（162.20±96.33） hours vs（235.00±107.90） hours（P0.05）;（8.40±2.17） scores vs（11.10±2.42） scores（P0.05）.Conclusion Ala-Gln treatment can significantly improve Gln,HSP70 levels in patients＇ serums,shorten duration of mechanical ventilation,improve APACHE Ⅱ score,suggesting t
出处
《临床荟萃》
CAS
2012年第4期298-300,303,共4页
Clinical Focus
