高支链氨基酸肠外营养支持对危重症病人肝肾功能保护作用的临床对照研究被引量：9

The protective effect of high branched-chain amino acid parenteral nutrition on liver and renal function in critically ill patients

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摘要目的:研究高支链氨基酸肠外营养(PN)液对危重症病人肝肾功能的支持和保护作用。方法:192例危重症病人为研究组,另172例危重症病人为对照组,对两组病人进行对照研究。两组病人PN时间均超过1周。研究组病人选用富含支链氨基酸的"复方氨基酸注射液(17AA-H)";对照组选用均衡性"复方氨基酸注射液(18AA-Ⅱ)",其他营养配置、用药和临床治疗无差别。比较两组病人PN前和PN后第1、3、5和7天的肝肾功能指标、APACHEⅡ评分等变化。结果:①PN治疗第3天后,两组病人总胆红素(TBIL)、谷丙转氨酶(AST)和谷草转氨酶(ALT)等均呈下降趋势;研究组治疗第7天TBIL水平显著低于对照组(P<0.05)。②PN治疗第3天后,仅研究组病人血清尿素氮(BUN)呈下降趋势,治疗第7天BUN水平显著低于对照组(P<0.05)。③PN治疗第3天后,两组病人APACHEⅡ评分均呈下降趋势,研究组显著低于对照组(P<0.05)。④PN治疗第7天后,研究组病人肝功能不全发生率由治疗前的28.6%降至19.8%,与治疗前比有显著性差异(P<0.05)。结论:富含支链氨基酸的PN液具有良好的肝肾器官保护作用,有利于病人康复。 Objective： To investigate the effect of infusion of branched-chain amino acid（BCAA） enriched parenteral nutrition（PN） in critically ill patients on organ protection.Methods： 364 ICU patients were enrolled,192 in the study group,and 172 critical in the control group.The sdudy group was infused with amino acid nutrient solution rich in BCAA（17AA-H）,and the control group with balanced amino acid nutrition（18AA-Ⅱ）.Two groups were compared in hepatic function,renal function and APACHE Ⅱ scores.Results： After treatment of PN TBIL and BUN in study group decreased more obviously than that in control group（P0.05）.The APACHE Ⅱ scores in study group decreased more obviously than that in control group（P0.05）.The incidence rate of hepatic insufficiency in study group was significantly decreased（19.8% vs 28.6%,P0.05） after 7 days of PN.Conclusion： High BCAA parenteral nutrition has favourable protective effect on liver and renal function in critically ill patients.

作者杨晓军冯涛马玉杰周文杰朱金源张珺丁欢靳忻周文艳

机构地区宁夏医科大学附属总医院重症医学科宁夏回族自治区第三人民医院内科

出处《肠外与肠内营养》 CAS 北大核心 2012年第6期347-350,共4页 Parenteral & Enteral Nutrition

关键词肠外营养支链氨基酸急性生理和慢性健康状况评估 Parenteral nutrition Branched chain amino acid APACHE Ⅱ

分类号 R459.7 [医药卫生—急诊医学]

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