丙氨酰谷氨酰胺對(duì)膿毒血癥GSH和GIn水平影響及臨床治療效果分析

摘要： 目的分析丙氨酰谷氨酰胺對(duì)膿毒血癥谷胱甘肽(GSH)、谷氨酰胺(GIn)水平影響及臨床治療效果。方法選取2015年1月-2017年6月醫(yī)院收治的膿毒血癥患者94例,根據(jù)隨機(jī)數(shù)字法不同分為對(duì)照組和試驗(yàn)組。對(duì)照組患者采用常規(guī)營(yíng)養(yǎng)支持,試驗(yàn)組患者采用常規(guī)營(yíng)養(yǎng)支持聯(lián)合丙氨酰谷氨酰胺靜脈勻速持續(xù)泵入,分析兩組患者臨床治療效果。結(jié)果治療后,試驗(yàn)組患者ALB、TF、GSH、GIn水平高于對(duì)照組,hs-CRP、LPS水平均低于對(duì)照組(P<0.05);試驗(yàn)組患者呼吸機(jī)和抗菌藥物使用時(shí)間分別為(4.75±1.66)d與(5.29±2.24)d,均短于對(duì)照組的(7.98±2.14)d、(9.65±3.00)d;試驗(yàn)組多器官功能障礙綜合征發(fā)生率為12.77%,低于對(duì)照組的31.91%(P<0.05)。結(jié)論丙氨酰谷氨酰胺治療膿毒血癥可有效改善機(jī)體營(yíng)養(yǎng)狀況,抑制炎癥因子的表達(dá),提高GSH、GIn水平,減少器官損傷,改善患者預(yù)后,且安全性高。
OBJECTIVE To analyze the effect of alanyl glutamine on glutathione(GSH)and glutamine(GIn)levels in sepsis patients and its clinical therapeutic effect.METHODS 94 patients with sepsis admitted in our hospital from Jan.2015 to Jun.2017 were selected,and divided into the control group and the experimental group according to the method of random number table.The control group was treated with conventional nutritional support,whereas the experimental group was treated with conventional nutritional support combined with continuous intravenous infusion of alanyl glutamine.The clinical therapeutic effect was analyzed for the two groups of patients.RESULTS After treatment,the levels of ALB,TF,GSH and GIn in the experimental group were significantly higher than those in the control group,while the levels of hs-CRP and LPS were significantly lower than those in the control group(P<0.05).The durations of ventilator and antibiotic use in the experimental group were(4.75±1.66)and(5.29±2.24)days,respectively,and those in the control group were(7.98±2.14)and(9.65±3.00)days,respectively.The incidence of multiple organ dysfunction syndrome was 12.77%in the experimental group,significantly lower than that in the control group(31.91%)(P<0.05).CONCLUSIONAlanyl glutamine treatment of sepsis can effectively improve the nutritional status of the patients,inhibit the expression of inflammatory factors,improve GSH and GIn levels,reduce organ damage,and improve the prognosis of patients,with high safety.