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纸质出版:2007
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张献菊.丙氨酰谷氨酰胺双肽全肠外营养在胃肠道肿瘤患者术后的应用[J].陆军军医大学学报(原第三军医大学学报),2007,29(11):1120-1122.
ZHANG Xian-ju.Application of total parenteral nutrition with alanyl-glutamine dipeptide in postoperative patients of gastrointestinal neoplasms[J].J Amry Med Univ (J Third Mil Med Univ),2007,29(11):1120-1122.
目的 探讨丙氨酰谷氨酰胺(Gla-Gln)双肽全肠外营养(total parenteral nutrition
TPN)在胃肠道肿瘤患者术后的应用。 方法 64 例胃肠道肿瘤患者术后分为常规TPN 组(对照组) 32 例和TPN + Gla-Gln 组(实验组) 32 例,所有患者术后第1~7 天等热量(96.0 kJ·kg
-1
·d
-1
)、等氮(0.25 g·kg
-1
·d
-1
)的肠外营养治疗,实验组另外添加0.5 g·kg
-1
·d
-1
的Gla-Gln双肽。观察血清白蛋白、血清前蛋白、氮平衡变化,并检测手术前后外周血IgG、IgM、IgA、C3 、C4 的变化。 结果 ①两组患者血清白蛋白、前白蛋白在术后第1天均有下降,与术前相比差异非常显著(P0.01),术后第8天时两组均有回升,但对照组回升较慢,两组比较有显著性差异(P0.05)。 ②两组患者术后第4天IgG、IgA、IgM值均低于术前,与术前相比两组均有非常显著的差异(P0.01),实验组术后第8天IgG、IgA、IgM明显回升并高于术前,与对照组比较有显著性差异(P0.05)。实验组术后第8天C3、C4值与对照组比较有显著性差异(P0.05)。③实验组术后第8天氮平衡明显优于对照组(P0.01)。 结论 丙氨酰谷氨酰胺双肽全肠外营养在胃肠道肿瘤手术患者中使用安全,有助于改善患者术后的营养状况,提高患者的免疫功能。
Objective To investigate the application of total parenteral nutrition with alanyl-glutamine dipeptide in postoperative patients of gastrointestinal neoplasms. Methods Sixty-four postoperative patients of gastrointestinal neoplasms were randomly divided into study group and control group. The patients in the two groups all received isocaloric (96.0 kJ·kg
-1
·d
-1
) and isonitrogen (0.25 g·kg
-1
·d
-1
) parenteral nutrition from postoperative day 1 to day 7
and the study group received additional alanyl-glutamine. The serum levels of albumin
pre-albumin
IgG
IgA
IgM
C3
C4 were measured before operation and on postoperative day 1 and 8. Nitrogen balance was calculated on postoperative day 1
4 and 8. Results Compared with preoperation
the serum levels of albumin and pre-albumin were both significantly decreased in two groups (P0.01). Compared with those of preoperation
IgG
IgM IgA levels were decreased significantly on preoperative day 4 in two groups (P0.01)
and increased in the study group on postoperative day 8 (P0.05). C3 and C4 levels in the study group were increased more than those in the control group (P0.05) on postoperative day 8. Nitrogen balance in the study group was better than those in the control group (P0.05) on postoperative day 8. Conclusion Alanyl-glutamine dipeptide is beneficial to postoperative patients of gastrointestinal neoplasms
and can improve their nutritional status
enhance their immune function.
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