谷氨酰胺强化的肠外营养对骨髓移植后病人的临床和代谢效应——随机、双盲和对比研究

被引：3

作者：

ThomasR.Ziegler.M.D.

DouglasW.Wilmore.M.D.

邓高月

机构：

来源：

中国临床营养杂志 | 1995年 / 04期

关键词：

肠外营养; 谷氨酞胺; 病人; 同种异体骨髓移植; 氮平衡; 谷氨酰胺; 谷-NH2; 对比研究; 双盲;

D O I：

暂无

中图分类号：

R459.3 [饮食疗法、临床营养学];

学科分类号：

100215 ;

摘要：

目的:确定骨髓移植后补充谷氨酰胺的肠外营养与标准肠外营养液比较能否改善氮潴留,减少住院并发症。设计:双盲、随机和对比临床研究。位置:大学教学医院。病人:45位因血液系恶性瘤而接受同种异体骨髓移植的成年人。介入:肠外营养从骨髓移植后的第一天开始。研究组补给L-谷氨酰胺(0.57g·kg-1·d-1),并供给估计需要的能量和蛋白质。对照组给予标准的、不含谷氨酰胺的、等氮等热卡营养液。监测:在开始的23个病人中,第4至第11天之间测定氮平衡,记录临床感染和细菌植入的发生率,至骨髓生长的时间,临床医疗指标及其他与住院并发症有关的数据。结果:研究开始时补充谷氨酰胺组（n=24）病人的临床情况与对照组（n=21）病人类似。两组病人的营养摄入相仿。然而,与对照组相比,补充谷氨酰胺组病人的氮平衡改善（-1.4±0.5g/d比-4.2±1.2g/d,P=0.002）。研究组病人发生临床感染者更少（3例比对照组的9例,P=0.041）。细菌植入的发生率也明显降低。接受谷氨酰胺的病人住院时间缩短（29±1天比36±2天,P=0.017）。结论:与接受标准肠外营养液的病人相比,接受谷氨酰胺肠外营养液的病人在骨髓移植后氮平衡改善,临床感染的发生率减少,细菌植入的发生率降低,住院时间缩短。而两组病人的发热发生率,抗菌素需要和中性粒细胞生

引用

页码：5 / 14

页数：10

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