血浆游离氨基酸在重症急性胰腺炎肠内营养后的变化分析  

Changes of Plasma Free Amino Acid Levels after Enteral Nutrition for Patients with Severe Acute Pancreatitis

作　　者：王德强[1] 柴虎林[1] 

机构地区：[1]包头医学院第一附属医院普外1科,内蒙古包头市014010

出　　处：《中国全科医学》2012年第20期2289-2291,共3页Chinese General Practice

基　　金：内蒙古科技厅资助项目(NK20090030)

摘　　要：目的探讨血浆中18种游离氨基酸在重症急性胰腺炎(SAP)患者肠内营养(EN)后的变化。方法入选27例SAP患者,随机分为肠外营养(PN)组(15例)和EN组(12例),入选15例健康人作为对照组。入选者在营养治疗前、治疗后10 d采空腹静脉血5 ml,采用氨基酸谱测定仪测定其血浆游离氨基酸的水平。结果营养治疗前,EN组和PN组患者血浆氨基酸水平均显著低于对照组,差异有统计学意义(P<0.05);EN组和PN组患者血浆氨基酸水平比较,差异无统计学意义(P>0.05)。营养治疗后,EN组较PN组患者血浆蛋氨酸、天冬氨酸、谷氨酰胺水平明显升高,苏氨酸水平明显降低,差异均有统计学意义(P<0.05)。营养治疗后,PN组组氨酸、精氨酸、脯氨酸和酪氨酸水平较治疗前明显升高,EN组亮氨酸、赖氨酸、蛋氨酸、组氨酸、精氨酸、脯氨酸水平较治疗前明显升高,差异均有统计学意义(P<0.05)。结论 EN能升高SPA患者血中某些游离氨基酸的水平,是治疗SAP有效的方法。Objective To investigate the changes of eighteen free amino acids in patients with severe acute pancreatitis after enteral nutrition（EN）.Methods Totally 27 patients were divided randomly into two groups：the parenteral nutrition（PN） group（n=15） and the EN group（n=12）.Another 15 age-matched healthy subjects were enrolled as the control group.Plasma free amino acid levels were determined by colorimetry.Results Before nutritional therapy,the plasma levels of these 18 amino acids were significantly lower than those in control group（P〈0.05）,but not so such difference was found between PN group and EN group（P〉0.05）.After nutritional therapy,compared with the PN group,plasma levels of methionine,asparagines,and glutaminate were significantly higher in EN group（P〈0.05）.After nutritional support,plasma histidine,arginine,proline and tyrosine levels significantly increased in PN group,whereas leucine,lysine,methionine,histidine,arginine,praline significantly increased in EN group when compared with the baseline levels..Conclusion EN can increases the plasma levels of some free amino acids in patients with severe acute pancreatitis,and thus may be a more safe,effective,and affordable method.

关 键 词：胰腺炎 肠内营养 胃肠外营养 氨基酸 

分 类 号：R576.1[医药卫生—消化系统]