精氨酸联合谷氨酰胺肠内营养对烧伤患者支持作用.docVIP

精氨酸联合谷氨酰胺肠内营养对烧伤患者支持作用 　　[摘要]目的 探讨联合应用精氨酸（A rg）和谷氨酰胺（G ln）的肠内营养（EN）对烧伤患者的影响。方法 将120例烧伤患者随机分成4组，每组30例，分别为A组（A rg）、G组（Gln）、AG组（Arg+Gln）和EN组（EN）。结果 治疗第14天后， 与EN组比较，A组、G组和AG组的PA、TF、ALB、STP浓度更显著增高，差异均具有统计学意义（P0.05）；A组、G组的细胞免疫水平与EN组相比，差异具有统计学意义（P0.05）；AG组与EN组相比，差异有极显著性意义（P0.01）；治疗后A组、G组、AG组的CRP、补体C3、C4与EN组相比，差异具有统计学意义（P0.05）。结论 A rg和G ln联合应用的EN比单用A rg 或G ln的EN更有效改善烧伤患者的营养状况、细胞免疫功能，抑制其应激反应的作用也更明显。 　　[关键词]肠内营养；精氨酸；谷氨酰胺；烧伤 　　Effect of enteral nutrition with arginine and glutamine on burned patients 　　GUO Yafang 　　Department of nutrition， The second people’s Hospital of Taiyuan City，Shanxi 03002 China 　　[Abstract]Objective： To evaluate the effect of A rg and G ln enriched EN effect on burned patients.Methods： One hundred twenty burned patients were randomly divided into 4 groups： Agroup（ arg inine enriched EN group） ， Ggroup （ glntamine supplemented EN group ） ， AGgroup （ arginine and glutamine enriched EN group） and EN group （ Routine EN group）. The distinct immune nutrients were added in to EN in the different groups for 14 consecutive days. The difference of the patients ‘nutrition status， immune function and stress status were analyzed. Results： After 14 day-treatment， compared with the EN group， the concentration of PA， TF， ALB， STP in A group，G group and AG group was more significantly increased， and the differences were statistically significant （P 0.05）； after treatment， compared with the EN group， the concentration of Cell-mediated immunity in A group and G group was significantly different（P0.05）； compared with the EN group， the index in AG group was significantly different（P 0.01）； compared with the EN group， the level of CRP， complement C3， C4 in A rg group， G group and AG group was significantly different（P005）. Conclusion： The usage of EN with arginine and glntamine is more effective in enhancing the cellular immune function and suppressing the inflammatory reaction in burned patients. 　　[Key words]Enteral nutrition； Arginine； Glutamine； Burned 　　烧伤后由于组