早期胃肠外补充谷氨酰胺对脓毒症患儿低蛋白血症的影响  

Effect of early parenteral glutamine supplementation on hypoalbuminemia in children with sepsis

作　　者：张红艳 杨茜 赖源[3] ZHANG Hongyan;YANG Qian;LAI Yuan(Department of Pediatrics,Changsha Third Hospital,Changsha 410015,Hunan,China;Department of Neurology,Changsha Third Hospital,Changsha 410015,Hunan,China;Institute of Pediatrics,Hunan Children's Hospital,Changsha 410007,Hunan,China)

机构地区：[1]长沙市第三医院儿科,湖南长沙410015 [2]长沙市第三医院神经内科,湖南长沙410015 [3]湖南省儿童医院儿科医学研究所,湖南长沙410007

出　　处：《中南医学科学杂志》2023年第1期123-125,共3页Medical Science Journal of Central South China

基　　金：湖南省卫生健康委员会项目(D202306016516);长沙市自然科学基金(Kq2202017)。

摘　　要：目的 观察早期胃肠外补充谷氨酰胺(Gln)对脓毒症患儿低蛋白血症的影响。方法 将脓毒症患儿62例均分为观察组与对照组。对照组患儿予以常规抗感染、对症支持、营养等治疗,观察组在对照组的基础上静脉滴注Gln。比较两组患儿入院第1天、第5天、第10天血清白蛋白(ALB)、前白蛋白(PA)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平及评估第三代小儿死亡危险评分(PRISMⅢ)、小儿危重病例评分(PCIS)。比较两组患儿住院天数、住院费用及病死率。结果 两组患儿治疗后各指标均有所改善。观察组第5天、第10天ALB、PA、PCIS均高于对照组(P<0.05),TNF-α、IL-6、PRISMⅢ均低于对照组(P<0.05)。观察组患儿住院天数、住院费用均少于对照组(P<0.05);两组患儿病死率差异无显著性(P>0.05)。结论 早期胃肠外补充Gln可减少脓毒症患儿ALB流失,利于改善病情,缩短住院天数,降低治疗费用。Aim To observe the effect of early parenteral Glutamine(Gln) supplementation on hypoproteinemia in children with sepsis. Methods 62 cases of children with sepsis were divided into observation group and control group. The children in the control group were given conventional anti infection, symptomatic support, nutrition and other treatments. The observation group was given intravenous Gln on the basis of the control group. The levels of serum albumin(ALB), prealbumin(PA), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), the third generation risk of death score(PRISM) and critical case score(PCIS) were compared between the two groups on the 1st, 5th and 10th day after admission. The hospitalization days, hospitalization expenses and mortality of children in the two groups were compared. Results The indexes of the two groups were improved after treatment. The values of ALB, PA and PCIS in the observation group were higher than those in the control group on the 5th and 10th day(P<0.05), while TNF-α, IL-6 and PRISM Ⅲ were lower than those in the control group(P<0.05). The hospitalization days and hospitalization expenses of the children in the observation group were less than those in the control group(P<0.05);There was no significant difference in mortality between the two groups(P>0.05). Conclusion Early parenteral Gln supplementation can reduce the loss of ALB in children with sepsis, which is beneficial to improve the condition, shorten the hospital stay and reduce the treatment cost.

关 键 词：谷氨酰胺 胃肠外 脓毒症 儿童 低蛋白血症 

分 类 号：R726[医药卫生—儿科]