全肠外营养加丙氨酰谷氨酰胺治疗重症肺炎并肠道功能衰竭患者的疗效

刘自双.全肠外营养加丙氨酰谷氨酰胺治疗重症肺炎并肠道功能衰竭患者的疗效[J].内科急危重症杂志,2022,28(5):395-397

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DOI：10.11768/nkjwzzzz20220510

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作者	单位	E-mail
刘自双	首都医科大学附属北京康复医院老年康复中心	weili2014@sina.com

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中文摘要:

目的：探讨全肠外营养（TPN）加丙氨酰谷氨酰胺治疗重症肺炎并肠道功能衰竭患者的疗效。方法：将96例重症肺炎并肠道功能衰竭患者依照随机数字表法分为对照组和治疗组，每组48例。对照组采用抗生素、机械通气等基础治疗，并给予TPN治疗；治疗组在TPN治疗中应用丙氨酰谷氨酰胺（20g/次，1次/d），2组均治疗4周。比较治疗前、后2组存活患者营养指标、细胞免疫功能指标、对肠道功能衰竭的疗效及药物不良反应。结果：治疗后，2组存活患者肱三头肌皮褶厚度、上臂肌围、白蛋白和血红蛋白、CD3+、CD4+和CD4+/CD8+升高，且治疗组更高（P均<0.05）；CD8+降低，且治疗组更低（P<0.05）；对肠道功能衰竭的疗效，治疗组的总有效率高于对照组（P均＜0.05）；2组用药不良反应比较，差异无统计学意义（P>0.05）。结论：在TPN治疗重症肺炎并肠道功能衰竭中，增加丙氨酰谷氨酰胺能改善营养状况，提高机体免疫功能。

英文摘要:

Objective: To investigate the efficacy of alanyl glutamine and total parenteral nutriention (TPN) in the treatment of patients with severe pneumonia with intestinal failure. Methods: Totally, 96 patients with severe pneumonia and intestinal failure admitted to hospitals were divided into control group and therapy group, with 48 cases in each group. The control group was treated with antibiotics, mechanical ventilation and other basic treatments, and given TPN treatment. The therapy group was given alaninyl glutamine (20g/time, 1time/d) in TPN treatment. The treatment time of two groups was 4 weeks. The nutritional indicators, the cellular immune function indexes of the surviving patients before and after treatment, efficacy of intestinal failure, adverse drug reactions in both groups were compared. Results: After treatment, the triceps skinfold thickness, upper arm muscle circumference, albumin and hemoglobin were increased (all P<0.05), and those in the therapy group was increased as compared with control group (all P<0.05). After treatment, the percentages of CD3+, CD4+ and CD4+/CD8+ of the two groups were increased (all P<0.05), and those in the therapy group were higher than those in the control group (all P<0.05);the percentage of CD8+ decreased, and that in the therapy group was lower than in the control group (all P<0.05). The efficacy of intestinal failure and the total effective rate in the therapy group were higher than in the control group (all P<0.05). There were no significant difference in the adverse drug reactions between the two groups (P>0.05). Conclusion: Increasing alanyl glutamine in the treatment of severe pneumonia and intestinal failure with TPN can improve nutritional indexes and increase the body's immune function.