丙氨酰谷氨酰胺对急性肺损伤患者血清肿瘤坏死因子、白细胞介素8水平及预后的影响  

Effect of alanyl-glutamine on TNF-α,IL-8 level and prognosis in patients with acute lung injury

作　　者：崔莹[1] 吴春雪[1] 李勇[1] 贾春梅[1] 杨龙[1] 闫寒[1] 李春学[1] 

机构地区：[1]沧州市中心医院急诊重症监护室,河北沧州061001

出　　处：《临床荟萃》2011年第21期1862-1864,共3页Clinical Focus

摘　　要：目的探讨丙氨酰谷氨酰胺(Ala-Gln)对急性肺损伤(ALI)患者血清肿瘤坏死因子(TNF-α)和白细胞介素8(IL-8)水平的影响及临床意义。方法 110例患者随机分为对照组(n=50)和谷氨酰胺(Gln)组(n=60),两组常规治疗一致,Gln组给予Ala-Gln 0.4g.kg-1.d-1共7天,对照组给予等量的生理盐水作为安慰剂。治疗前1天及治疗后7天检测血清TNF-α、IL-8水平,同时进行Murray肺损伤评分(MLIS)及急性生理和慢性健康评分(APACHEⅡ评分),并观察其变化。结果治疗前与治疗后比较,Gln组血清TNF-α、IL-8、MLIS、APACHEⅡ评分显著下降,TNF-α(69.20±16.46)ng/L vs(33.90±8.5)ng/L(P<0.01);IL-8(144.60±29.10)ng/L vs(61.20±13.85)ng/L(P<0.01);MLIS(1.93±0.85)分vs(0.94±0.87)分(P<0.01);APACHEⅡ评分(16.60±4.40)分vs(8.40±2.17)分(P<0.01)。与对照组治疗后比较,Gln组治疗后血清TNF-α、IL-8、MLIS、APACHEⅡ评分亦显著下降,TNF-α(50.70±17.60)ng/L vs(33.90±8.5)ng/L(P<0.01);IL-8(85.10±30.40)ng/L vs(61.20±13.85)ng/L(P<0.01);MLIS(1.52±0.89)分vs(0.94±0.87)分(P<0.01);APACHEⅡ评分(11.10±2.42)分vs(8.40±2.17)分(P<0.01)。结论 ALI患者补充Gln可降低血清TNF-α、IL-8水平,有利于促进脏器功能恢复,改善患者预后。Objective To evaluate the effect and clinical significance of alanyl-glutamine（Ala-Gln） on tumor necrosis factor-alpha（TNF-α）,interleukin-8（IL-8） level and prognosis in patients with acute lung injury（ALI）. Methods One hundred and ten patients were randomly divided into control group（n=50） and glutamine（Gln） group（n=60）,the conventional therapies of two groups were consistent,the patients in Gln group were assigned to receive Ala-Gln at the dose of 0.4 g·kg-1·d-1 for seven days,the patients in control group were assigned to receive the same dose normal saline as placebo.The levels of TNF-α and IL-8 were measured one day before treatment and seven days after treatment,Murray lung injury scores（MLIS） and APACHEⅡ scores were also observed at the same time. Results In Gln group,comparison between pre-and post-treatment,the levels of TNF-α,IL-8 and the scores of MLIS,APACHEⅡ were significantly lower,TNF-α（69.20±16.46） ng/L vs（33.90±8.5） ng/L（P0.01）;IL-8（144.60±29.10） ng/L vs（61.20±13.85） ng/L（P0.01）;MLIS（1.93±0.85） scores vs（0.94±0.87） scores（P0.01）;APACHEⅡ（16.60±4.40） scores vs（8.40±2.17） scores（P0.01）.Compared with control group in post-treatment,Gln group showed decreases in TNF-α,IL-8,MLIS and APACHEⅡ,TNF-α（50.70±17.60） ng/L vs（33.90±8.5） ng/L（P0.01）;IL-8（85.10±30.40） ng/L vs（61.20±13.85） ng/L（P0.01）;MLIS（1.52±0.89） scores vs（0.94±0.87） scores（P0.01）;APACHEⅡ（11.10±2.42） scores vs（8.40±2.17） scores（P0.01）. Conclusion Patients with ALI in complementing Gln decreases the level of TNF-α and IL-8,promotes the function of organs and improves prognosis.

关 键 词：呼吸窘迫综合征 成人 谷氨酰胺 肿瘤坏死因子Α 白细胞介素8 

分 类 号：R563[医药卫生—呼吸系统]