丙氨酰谷氨酰胺治疗ICU脓毒症患者疗效及对血清CRP ETX和HBP水平的影响  

Efficacy of Alanyl-Glutamine in the Treatment of Patients with Sepsis in ICU and Its Influence on Serum CRP,ETX and HBP Levels

作　　者：陈宇晟 刘小敏 CHEN Yusheng;LIU Xiaomin(The Affiliated Hospital of Hubei University of Arts and Science / Xiangyang Central Hospital, Hubei Xiangyang 441003, China)

机构地区：[1]湖北文理学院附属医院/湖北省襄阳市中心医院,湖北襄阳441003

出　　处：《河北医学》2021年第8期1285-1290,共6页Hebei Medicine

基　　金：湖北省卫生健康委员会科研课题,(编号:WJ2019Q018)。

摘　　要：目的:探讨丙氨酰谷氨酰胺治疗ICU脓毒症患者疗效及对血清C-反应蛋白(CRP)、内毒素(ETX)和肝素结合蛋白(HBP)水平的影响。方法:选取2019年2月至2021年2月我院ICU收治的152例脓毒症患者为对象,采用随机数字表进行简单随机分组,分为观察组和对照组各76例,对照组给予常规治疗,观察组在对照组基础上给予丙氨酰谷氨酰胺治疗,比较两组临床疗效、机械通气时间、住院时间、急性生理和慢性健康状况Ⅱ(APACHEⅡ)评分和血清CRP、ETX、HBP水平及肝功能指标[乳酸(LAC)、谷草转氨酶(AST)、谷丙转氨酶(ALT)]、营养指标[白蛋白(ALB)、血红蛋白(Hb)、转铁蛋白(TF)]和免疫指标[免疫球蛋白(IgA、IgG、IgM)和补体(C3、C4)]。结果:观察组治疗有效率高于对照组(84.00%vs66.77%)(P<0.05);观察组机械通气时间和住院时间短于对照组(P<0.05);治疗后两组APACHEⅡ评分和血清CRP、ETX、HBP、LAC、AST、ALT水平均降低,ALB、Hb、TF、IgA、IgG、IgM、C3、C4水平均升高(P<0.05),且观察组APACHEⅡ评分和血清CRP、ETX、HBP、LAC、AST、ALT水平低于对照组,ALB、Hb、TF、IgA、IgG、IgM、C3、C4水平高于对照组(P<0.05)。结论:丙氨酰谷氨酰胺治疗ICU脓毒症患者疗效显著,可降低血清CRP、ETX和HBP水平,改善机体营养状况和肝功能,提高免疫功能。Objective:To investigate the efficacy of alanyl-glutamine in the treatment of patients with sepsis in ICU,and its influence on serum C-reactive protein(CRP),endotoxin(ETX)and heparin-binding protein(HBP)levels.Methods:From February 2019 to February 2021,152 patients with sepsis in ICU of the hospital were selected and divided into observation group and control group,76 cases in each group,with random number table for simple random grouping.The control group received conventional treatment,and the observation group was treated with alanyl-glutamine on the basis of conventional treatment.Clinical effects,mechanical ventilation time,hospitalization time,acute physiology and chronic health evaluation II(APACHEII)scores,serum CRP,ETX and HBP levels,liver function indicators[lactate(LAC),aspartate aminotransferase(AST),alanine aminotransferase(ALT)],nutritional indicators[albumin(ALB),hemoglobin(Hb),transferrin(TF)],and immune indicators[immunoglobulins(IgA,IgG,IgM)and complements(C3,C4)]were compared between the two groups.Results:The effective rate of treatment in the observation group was higher than that in the control group(84.00%vs.66.77%)(P<0.05).The mechanical ventilation time and hospital stay of the observation group were shorter than those of the control group(P<0.05).After treatment,the levels of serum CRP,ETX,HBP,LAC,AST and ALT were reduced,while the levels of ALB,Hb,TF,IgA,IgG,IgM,C3 and C4 were increased(P<0.05).Meanwhile,the APACHEⅡscore and levels of serum CRP,ETX,HBP,LAC,AST and ALT in the observation group were lower than those in the control group,while the levels of ALB,Hb,TF,IgA,IgG,IgM,C3 and C4 were higher than those in the control group(P<0.05).Conclusion:Alanyl-glutamine is effective in the treatment of patients with sepsis in ICU.It can lower serum CRP,ETX and HBP levels,improve nutritional status and liver function,and improve immune function.

关 键 词：脓毒症 丙氨酰谷氨酰胺 C-反应蛋白 内毒素 肝素结合蛋白 

分 类 号：R47[医药卫生—护理学]