肠外营养中不同剂量丙氨酰谷氨酰胺对结直肠癌术后患者营养状况、炎症因子和免疫球蛋白水平的影响  

Effects of different doses of alanyl glutamine in parenteral nutrition on nutritional status,inflammatory factors and immunoglobulin levels in patients with colorectal cancer after operation

作　　者：李扬 庄佳芳 徐斌 陈战 欧阳山丹 LI Yang;ZHUANG Jia-fang;XU Bin;CHEN Zhan;OUYANG Shan-dan(Department of Pharmacy,the 73rd Army Hospital of the Chinese People's Liberation Army,Xiamen 361001,Fujian,China;Department of General Surgery,the 73rd Army Hospital of the Chinese People's Liberation Army,Xiamen 361001,Fujian,China)

机构地区：[1]中国人民解放军陆军第七十三集团军医院药剂科,福建厦门361001 [2]中国人民解放军陆军第七十三集团军医院普外科,福建厦门361001

出　　处：《川北医学院学报》2024年第10期1411-1414,共4页Journal of North Sichuan Medical College

摘　　要：目的:探究肠外营养中不同剂量丙氨酰谷氨酰胺(Ala-Gln)对结直肠癌术后患者营养状况、炎症因子和免疫球蛋白水平的影响。方法:选取120例结直肠癌患者为研究对象,按干预方式不同将患者分为低剂量组和高剂量组,每组各60例。两组患者均从术后第1天开始行肠外营养支持,1次/d,输注10~15 h/次,连续输注7 d。其中,低剂量组的营养剂中Ala-Gln占氨基酸总量的20%;高剂量组的营养剂中Ala-Gln占氨基酸总量的30%。比较两组患者营养状况[前白蛋白(PA)、总蛋白(TP)、白蛋白(ALB)、血红蛋白(Hb)]、炎症因子[C反应蛋白(CRP)、白细胞介素6(IL-6)]、免疫球蛋白[免疫球蛋白G(IgG)、IgA、IgM]、胃肠道症状及术后康复情况。结果:治疗后,两组患者血清PA、TP、ALB、Hb水平比较,差异均无统计学意义(P>0.05);高剂量组患者血清CRP、IL-6水平均低于低剂量组(P<0.05);IgG、IgA、IgM水平均高于低剂量组(P<0.05)。两组患者胃肠道不适总发生率、术后并发症总发生率比较,差异均无统计学意义(P>0.05)。高剂量组患者术后住院时间短于低剂量组(P<0.05)。结论:高剂量和低剂量Ala-Gln肠外营养均可有效改善结直肠癌术后患者营养状况,但高剂量Ala-Gln抑制炎症和提高免疫功能的作用更佳,且促进患者术后康复。Objective:To investigate the effects of different doses of alanyl glutamine(Ala-Gln)in parenteral nutrition on nutritional status,inflammatory factors and immunoglobulin levels in patients with colorectal cancer after surgery.Methods:A total of 120 patients with colorectal cancer were selected,according to the different intervention methods,they were divided into low dose group and high dose group,60 cases in each group.The two groups were given parenteral nutrition support from the first day after operation,once a day,10~15 h/time,continuous infusion for 7 days.Among them,Ala-Gln accounted for 20%of the total amino acid in the low-dose group,and Ala-Gln accounted for 30%of the total amino acid in the high-dose group.The nutritional status[prealbumin(PA),total protein(TP),albumin(ALB),hemoglobin(Hb)],inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)],immunoglobulin[immunoglobulin G(IgG),IgA,IgM],gastrointestinal symptoms and postoperative rehabilitation were compared between the two groups.Results:There was no significant difference in serum PA,TP,ALB and Hb levels between the two groups after treatment(P>0.05).After treatment,high-dose group's levels of serum CRP and IL-6 were lower than low-dose group s(P<0.05).The levels of IgG,IgA and IgM in the high-dose group were higher than those in the low-dose group(P<0.05).There was no significant difference in the total incidence of gastrointestinal discomfort and incidence of postoperative complications between the groups(P>0.05).The postoperative hospital stay in the high-dose group was shorter than that in the low-dose group(P<0.05).Conclusion:Both high-dose and low-dose Ala-Gln parenteral nutrition can effectively improve the nutritional status of patients after colorectal cancer surgery.Among them,high-dose Ala-Gln has a better effect on inhibiting inflammation and improving immune function,and promotes postoperative rehabilitation of patients.

关 键 词：丙氨酰谷氨酰胺 结直肠癌 肠外营养 营养状况 炎症因子 免疫球蛋白 

分 类 号：R735.3[医药卫生—肿瘤]