联合应用谷氨酰胺和生长激素对食管癌患者术后蛋白代谢和免疫状况的影响被引量：7

Effect of combined supplementation of glutamine and recombinant human growth hormone on immunologic function and protein metabolism in postoperative patients with esophagus carcinoma

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摘要目的研究谷氨酰胺和重组人生长激素联合应用对食管癌患者术后蛋白代谢、免疫状况的影响。方法将60例食管癌患者随机分为对照组、谷氨酰胺组、谷氨酰胺+生长激素组,三组均于术后给予7 d胃肠外营养,其中谷氨酰胺组按每天0.4 g/kg的剂量加用丙氨酰谷氨酰胺注射液(力肽),谷氨酰胺+生长激素组除了按每天0.4 g/kg的剂量加用谷氨酰胺外,同时还皮下注射8 IU/d重组人生长激素(珍怡),并分别于手术前及手术后第2天、第6天测量血清白蛋白水平,T细胞亚群、IgA、IgG、IgM,并与对照组加以比较。结果谷氨酰胺组的血清白蛋白、IgA、IgG在术后第6天分别为(42.8±3.36)g/L、(2.74±2.2)g/L和(10.8±2.2)g/L,较对照组有显著的改善。谷氨酰胺+生长激素组的血清白蛋白、IgA、IgG在术后第6天分别为(48.74±3.24)g/L、(3.12±1.7)g/L和(13.03±1.7)g/L,较对照组及谷氨酰胺组均有显著的改善。但IgM及T细胞亚群改变不显著。结论食管癌患者在术后常规TPN治疗的基础上,联合应用谷氨酰胺加重组人生长激素可以更好地改善患者术后的蛋白代谢及体液免疫水平。 Objective To investigate the effect of combined supplementation of glutamine and recombinant human growth hormone on protein metabolism and immunologic function in postoperative patients with esophagus carcinoma. Methods Sixty patients with esophagus carcinoma were randomly divided into control （C,n=20）, glutamine （Gin, n=20） and Gin plus rhGH （Gin ＋ rhGH, n =20） groups. All patients were given parenteral nutrition after operation for seven days. The patiens in Gin group were given alanyl glutamine solution at a dose of 0.4g/kg every, day. In Gin ＋ rhGH group, the patiens were given alanyl glutamine solution at a dose of 0.4 g/kg and injection of rhGH 8IU every day. The level of serum albumin （ALB） ,T lymphocyte subgroups, IgA, IgG, IgM were observed. Results The levels of ALB, lgA and IgG were（42.8 ±3.36）g/L, （2.74 ±2.2）g/L and（ 10.8 ±2.2）g/L in Gin group on the sixth day after operation and were higher than those in the C group（ P 〈 0. 05）. In Gin ＋ rh GH group, the levels of ALB, IgA and IgG were （48.74±3.24） g/L, （3.12 ± 1.7） g/L and （ 13.03 ± 1.7） g/l, on the sixth day after operation and were higher than those in the C group（P 〈 0.01 ） and Gin group（P 〈 0.05）. Conclusion Combined supplementation of glutamine and recombinant human growth hormone as enhanced TPN therapy can improve the postoperative protein metabolism and immunologic state in patients with esophagus carcinoma.

作者吴蔚何萍王海东杨康廖克龙

机构地区第三军医大学附属西南医院胸心外科

出处《中国肿瘤临床与康复》 2007年第4期380-383,共4页 Chinese Journal of Clinical Oncology and Rehabilitation

关键词食管肿瘤全胃肠外营养谷氨酰胺生长激素 Esophagus neoplasms Total parcnteral alimcntation Glutamine Growth hormone

分类号 R735.1 [医药卫生—肿瘤] R730.9 [医药卫生—肿瘤]

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