丙氨酰谷氨酰胺双肽对存在营养风险胃癌患者临床结局的影响  

Impact of Alanyl-Glutamine Dipeptide on Clinical Outcome for Gastric Cancer Patients with Nutritional Risk

作　　者：陈博[1] 徐阿曼[1] 胡孔旺[1] 韩文秀[1] 张嘉炜[1] 李霆[1] 韦之见[1] 熊茂明[1] 孟翔凌[1] 

机构地区：[1]安徽医科大学第一附属医院胃肠外科,安徽合肥230022

出　　处：《中国普外基础与临床杂志》2016年第7期798-804,共7页Chinese Journal of Bases and Clinics In General Surgery

基　　金：安徽省自然科学基金(项目编号:1508085QH152);国际教育类教学研究项目(项目编号:gjjyxm201406);安徽医科大学教学质量工程研究项目(项目编号:111)~~

摘　　要：目的评估全胃切除术后应用丙氨酰谷氨酰胺双肽对存在营养风险胃癌患者临床结局的影响。方法自2015年3月至2015年8月,对所有新入院胃癌住院患者进行营养风险筛查,确定手术方式,按随机原则将患者分为谷氨酰胺组(glutamine,Gln组)和对照组,对比分析2组患者的临床资料,如肝肾功能指标、并发症及营养相关住院时间。结果共纳入40例患者,2组患者术前基线资料一致。研究发现在术后第3天和第7天,Gln组患者的血浆白蛋白水平高于对照组,分别为(33.9±5.6)g/L比(30.8±4.0)g/L(P=0.04)和(36.6±3.9)g/L比(33.9±4.2)g/L(P=0.04)。术后Gln组患者CD4^+/CD8^+细胞免疫指标较对照组显著增高(1.7±0.7比1.2±0.3,P<0.05)。Gln组在肠道功能的恢复时间〔(65.7±5.3)h比(71.6±7.2)h,P<0.01)〕和术后营养相关住院时间〔(10.1±1.8)d比(11.7±1.9)d,P<0.01)〕均短于对照组。在整个观察过程中未发现药物相关性严重不良反应。结论对存在营养风险的全胃切除患者应用丙氨酰谷氨酰胺具有改善患者部分临床结局指标功能。Objective To evaluate the impact of using alanyl-glutamine dipepticte on ctmtcal outcome for gastric cancer patients with nutritional risk after total gastrectomy. Methods This study was carried out in the period from March to August 2015. The nutritional risk was screened by continuous sampling method in the new hospitalized patients with gastric cancer who would undergo total gastrectomy. The patients were grouped randomly. Alanyl-glutamine was given to the experimental group patients. The clinical data of the two groups were analyzed, such as the laboratory parame- ters of nutritional status and hepatorenal function, complications of surgery, the nutrition-related hospitalization day, etc. Results The preoperative data were consistent in the two groups of the included 40 cases. The results showed, in the third and seventh days after surgery, the level of plasma albumin was higher in the experimental group than in the control group （33.9±5.6） g/L vs. （30.8±4.0） g/L and （36.6±3.9） g/L vs. （33.9±4.2） g/L, respectively）. Also, the CD4＋/CD8＋ cells immune index was significantly improved in the experimental group after surgery （ 1.7±0.7 vs 1.2±0.3, P〈0.05 ）. The recovery time of intestinal function （65.7±5.3） h vs. （71.6±7.2）h, P〈0.01）3 and nutrition-related hospitalization day （10.1±1.8） d vs. （ 11.7±1.9 ）d, P〈0.01） ] in alanyl-glutamine dipeptide group were shorted than that in the control group. No serious adverse drug reactions were found in the patients during the treatment period. Conclusion Application alanyl- glutamine to the patients with nutritional risk after total gastrectomy could partly improve clinical outcome indicators.

关 键 词：营养风险筛查 营养不良 丙氨酰谷氨酰胺 胃癌 临床结局 

分 类 号：R735.2[医药卫生—肿瘤]