Abstract:

Objective:To observe the effect of hypocalorie PN with growth hormone and glutamine on the course of disease in severe ill patients. Methods:Between April 2004 and September 2004,30 severe ill patients were performed the treatment of conventional PN，hypocalorie PN+rhGH，hypocalorie PN+rhGH+Gln to evaluate the difference between plasma prealbumin，transferrin,nitrogen balance,endotoxin,APACHE Ⅱat the 1st,5th and 8th day,3MH,lactulose mannitol ratio at the 8th day and the prognosis at the end of treatment. Results:At the 8th day，the level of nitrogen balance,3MH,lactulose mannitol ratio,endotoxin,APACHE Ⅱ，the length of stay in the ICU in hypocalorie PN+ rhGH+Gln group was better than conventional PN group and hypocalorie PN+rhGH group. Conclusions:Hypocalorie PN+rhGH+Gln is beneficial to the severe ill patients by increasing protein synthesis.It also has a positive effect on the recovery of intestinal permeability and the improvement of the prognosis.

Key words: Hypocalorie PN, Growth hormone, Glutamine

摘要：

目的:观察生长激素（rhGH）联合谷氨酰胺（Gln）低热量肠外营养(PN)对外科重症病人的优化营养支持作用。方法:2004年4～9月，上海交通大学附属第六人民医院对30例外科重症病人施行常规PN、低热量PN+rhGH、低热量PN+rhGH+Gln治疗。在第1、5、8天分别观察血浆前白蛋白、转铁蛋白、氮平衡、血内毒素、APACHE Ⅱ评分；第8天测3甲基组氨酸、尿乳果糖/甘露醇比值；治疗结束后分析预后的变化。结果:低热量PN+rhGH+Gln组病人第8天时，氮平衡、尿3MH、尿乳果糖/甘露醇比值、血内毒素水平、APACHE Ⅱ评分以及治疗期间ICU住院时间低于常规PN组和低热量PN+rhGH组。结论:rhGH联合Gln低热量PN能减轻机体代谢负担，促进蛋白合成和肠道屏障功能恢复，改善预后。

关键词: 低热量肠外营养, 生长激素, 谷氨酰胺