强化谷氨酰胺的肠内营养对严重颅脑损伤患者应激状态和免疫功能的影响

山东大学学报(医学版) ›› 2009, Vol. 47 ›› Issue (7): 115-116.

强化谷氨酰胺的肠内营养对严重颅脑损伤患者应激状态和免疫功能的影响

陈立勇¹，谭艳榕²，张洁¹，甄昌奎¹

1. 山东大学附属省立医院营养科，济南 250021； 2. 山东省医学影像学研究所，济南 250021

收稿日期:2009-03-15 发布日期:2009-07-16
作者简介:陈立勇 (1973- ), 男,主治医师，硕士研究生，主要从事营养与疾病的研究。 Email:chenle73@sina.com

Effect of glutamine enhanced enteral nutrition on stress status and immune function of patients with severe craniocerebral injury

CHEN Liyong ^1,　TAN Yanrong ²,　ZHANG Jie¹,　ZHEN Changkui ¹

1. Department of Nutrition Service Shandong Provincial Hospital Affiliated to Shandong University;
2.Shandong Institute of Medicial Imaging Research, Jinan 250021, China

Received:2009-03-15 Published:2009-07-16

摘要/Abstract

摘要：

目的观察应用强化谷氨酰胺的肠内营养对严重颅脑损伤患者应激和免疫状态的影响。方法72例严重脑损伤患者随机分为实验组和常规组，每组36例，放置鼻-十二指肠管，均使用肠内营养支持泵均匀持续滴注的鼻饲方法，实验组使用肠内营养制剂强化谷氨酰胺，常规组使用肠内营养制剂加蛋白粉，两者氨热比值保持一致。2周后抽静脉血，观察两组患者实验前后的应激状态［C3、C4、C反应蛋白(CRP)］和免疫功能（CD4+、CD8+、CD4+/CD8+、IgA、IgG、IgM）的变化。结果实验结束时实验组C3、C4、CRP低于实验前，实验组C3、C4、CRP含量均低于常规组，差异有统计学意义。实验结束时实验组CD4+、CD4+/CD8+、IgA、IgG均高于实验前，差异有统计学意义，CD4+、CD4+/CD8+、IgA、IgG均高于常规组，差异有统计学意义，两组的CD8+数量的差异无统计学意义(P＞0.05)。结论强化谷氨酰胺的肠内营养能有效地改善严重脑损伤患者的应激和免疫状态。

关键词: 谷氨酰胺；颅脑损伤；应激状态；免疫功能

Abstract:

To evaluate the influence of glutamine (Glu) enriched enteral nutrition(EN) on stress status and immune function under severe brain injuries. Methods72 patients with severe brain injury were randomly divided into the experimental group and the control group. Glutamine enriched enteral nutrition(EN) was given to the experimental group and protein powder enriched enteral nutrition(EN) was given to the control group with equal calorie and equal nitrogen using continuous infusion pump uniform of the nasal feeding methods through a noseduodenal tube. Blood was drawn from a vein after 2 weeks and changes of stress status(C3, C4, and CRP) and immune function(CD4+, CD8+, CD4+/CD8+, IgA, IgG, and IgM) were evaluated. ResultsAt the end of the experiment, levels of C3, C4, and CRP of the experimental group were lower than those before the experiment and lower than those of the control group with significant differences. Levels of CD4+, CD4+/CD8+, IgA, and IgG of the experimental group were higher than those of the control group and those before the experiment with significant differences. There were no significant statistical differences of CD8+ between the two groups. ConclusionsGlutamine enriched nutrition can effectively improve the stress status and immune function of the brain.

Key words: Glutamine; Craniocerebral injury; Stress status; Immune function

中图分类号:

R651.15

. 强化谷氨酰胺的肠内营养对严重颅脑损伤患者应激状态和免疫功能的影响[J]. 山东大学学报(医学版), 2009, 47(7): 115-116.

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