谷氨酰胺双肽在异基因外周血造血干细胞移植中的应用  

Clinical application of L-glutamine in allogeneic peripheral blood stem cell transplantation

作　　者：宋永平[1] 房佰俊[1] 张龚莉 林全德[1] 魏旭东[1] 

机构地区：[1]河南省肿瘤医院河南省血液病研究所,河南郑州450008

出　　处：《中国实用内科杂志》2007年第20期1619-1621,共3页Chinese Journal of Practical Internal Medicine

基　　金：河南省杰出青年基金(0612000900);河南省医学科技创新人才工程(200590)

摘　　要：目的研究谷氨酰胺双肽(Gln)在异基因外周血造血干细胞移植(allo-PBSCT)中的作用。方法选取2001—2006年河南省肿瘤医院进行allo-PBSCT的血液系统肿瘤患者36例,随机分为标准化全胃肠外营养液组(标准组,n=13)和加用Gln的全胃肠外营养液组(Gln组,n=23),造血干细胞输注后第1天开始给予全胃肠外营养。结果两组患者营养物质的摄入基本相同,标准组中性粒细胞(ANC)≥0.5×109/L的时间为(13.2±3.1)d,Gln组为(13.7±3.5)d(P>0.05);Gln组有6例发生黏膜炎,标准组为11例(P<0.05);Gln组1例发生严重腹泻,标准组有5例(P<0.05);Gln组有3例发生临床感染,标准组有7例(P<0.05);Gln组抗生素治疗时间为(12.4±2.5)d,标准组为(15.9±2.6)d(P<0.05);Gln组住无菌病房时间缩短[(29.9±1.4)d对(33.2±2.6)d,P<0.05)]。结论两组患者中性粒细胞移植成功的时间差异无显著性意义,但Gln能减少黏膜炎、严重腹泻、临床感染的发生率,缩短抗生素治疗时间及住无菌病房的时间。Objective To study the effect of L-glutamine （Gln） on allogeneic peripheral blood stem cell transplantation （allo-PBSCT）. Methods A total of thirty six patients receiving allo-PBSCT for hematologic malignancies between 2001 and 2006 in Henan Tumor Hospital were divided into two groups：the group of standard total parenteral nutrition （ standard group,n = 13 ）and the group of standard total parenteral nutrition with Gln（ Gln group, n = 23 ）. Parenteral nutrition was initiated at the day after peripheral blood stem cell transplantation（day 1 ）. Results Nutrient intake was similar in both groups. The time to reach 〉 0. 5 × 10^9/L neutrophils was （ 13. 2 ± 3. 1 ） days in the standard group, and （ 13.7 ± 3. 5 ） days in the Gln group （ P 〉 0. 05 ）. Six patients （ 6/23 ） in the Gln group developed mucositis and 11 cases （ 11/11 ） in the stand- ard group （ P 〈 0. 05 ）. One patients （ 1/23 ） in the Gln group developed severe diarrhea and 5 cases （ 5/11 ） in the standard group （ P 〈 0. 05 ）. Seven patient （ 6/11 ） in the standard group developed clinical infection, however, 3 cases （ 3/23 ） in the Gln group did it（ P 〈 0. 05 ）. The time of antibiotic requirements was（ 15.9 ± 2. 6 ）days in the standard group and（ 12.4 ± 2. 5）days in the Gln group （P 〈 0. 05）. Free-germ ward stay was shortened in the Gln group [ （29. 9 ± 1.4）days vs （ 33.2 ± 2. 6） days, P 〈 0.05 ]. Conclusion There is no difference in the time to neutrophil engraftment between the two groups. L-glutamine can diminish the incidence of mucositis and severe diarrhea,and the rates of clinical infection. L-glutamine can also shorten free-germ ward stay and antibiotic requirements.

关 键 词：造血干细胞移植 异基因 谷氨酰胺 外周血 

分 类 号：R5[医药卫生—内科学]