丙氨酰谷氨酰胺治疗高龄患者重症肺炎  

Effect of Alanyl-glutamine on Aged Patients with Severe Pneumonia

作　　者：李曙平[1] 杜伟华[1] 李娟[1] 

机构地区：[1]广州军区武汉总医院干部病房一科,武汉430070

出　　处：《药物流行病学杂志》2010年第5期245-247,共3页Chinese Journal of Pharmacoepidemiology

摘　　要：目的:探讨丙氨酰谷氨酰胺(Ala-Gln)在高龄重症肺炎患者治疗中的作用。方法:56例医院获得性重症肺炎的高龄患者,随机分成应用丙氨酰谷氨酰胺(Ala-Gln)组30例和对照组26例,对照组给予抗感染、营养支持、对症治疗等常规治疗,Ala-Gln组在此基础上,给予丙氨酰谷氨酰胺10g加入复方氨基酸250ml中,ivd bid,共14d。治疗前后分别对两组患者进行肠功能评分,测定血清白蛋白(Alb)、免疫球蛋白(IgG)、总淋巴细胞计数、C反应蛋白(CRP)、氮平衡,肝功能、肾功能。结果:治疗后两组患者肠功能评分比较差异有统计学意义(P<0.01);C反应蛋白(CRP)与APACHEⅡ评分两组均有下降(P<0.05),Ala-Gln组较对照组下降更为明显(P<0.05)。Ala-Gln组肺炎平均治愈好转时间为(19±3)d,较对照组(26±4)d明显缩短。结论:高龄重症肺炎患者及时补充丙氨酰谷氨酰胺,可减少有害或过度的炎症反应,维持正常肠粘膜屏障功能及正常免疫反应,有效防治肠功能衰竭,有利于肺炎的控制,从而提高救治率。Objective： To study the effect of alanyl-glutamine （Ala-GIn） on aged patients with severe pneumonia. Methods： The hospital acquired 56 cases of patients with severe pneumonia, who were randomized in two groups： Ala- Gln group in 30 cases and controlled group in 26 cases Both groups were cared with anti-infection, nutrition support and symptomatic treatment, during which Ala-Gln group was supplemented with 10g alanyl-glutamine amid 250ml amino acid intravenous drip in 14 days,two times each. Before and after the treatment,both groups were monitored over their intestinal functions and measured over their Alb, IgG, total lymphocytes count, C-reactive protein, nitrogen balance, blood routine, liver and kidney function examinations. Result： There were statistical differences between the groups involving intestinal function monitoring （P 〈 0. 05 ） ,while it saw decreases in C-reactive protein and APACHE II （P 〈 0. 05 ）. Ala-Gln group presented more obvious decreases （ P 〈 0.05 ） than the controlled group. The average time of curing these pneumonia patients in Ala-Gln group was about 19 ± 3 days, while that of the controlled group was 26 ± 4. Conclusion： The supplement treatment with alanyl-glutamine can curb or reduce increased inflammation, thus maintaining normal intestinal mucosal barrier and immune response to prevent intestinal failure effectively, as well as help controlling pneumonia so as to improve the cure rate.

关 键 词：丙氨酰谷氨酰胺 重症肺炎/高龄 肠粘膜屏障 

分 类 号：R977.4[医药卫生—药品]