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肠外营养补充谷氨酰胺可改善厌食症患者的免疫状态。

Glutamine-supplemented total parenteral nutrition improves immunological status in anorectic patients.

机构信息

Department of Internal Medicine, Messina University Hospital, School of Medicine, University of Messina, Messina, Italy.

出版信息

Nutrition. 2010 Jun;26(6):677-81. doi: 10.1016/j.nut.2009.10.008. Epub 2010 Feb 1.

Abstract

OBJECTIVE

Glutamine is an important substrate for critical cells of the immune system, in particular lymphocytes and macrophages, and it is considered a conditionally essential amino acid. Several studies have indicated that glutamine-enriched total parenteral nutrition improves immunologic status and shortens length of stay of critically ill patients. We investigated the effect of total parenteral nutrition supplemented with glutamine on the immune system in anorectic patients.

METHODS

Thirty-six anorectic patients were randomized to receive standard parenteral nutrition or parenteral nutrition supplemented with glutamine 0.18 g kg(-1) d(-1) for 20 d. To evaluate the immune system status, we determined serum levels of neopterin and insulin growth factor-1 and lymphocyte count at baseline and after 10 and 20 d from the beginning of the therapy.

RESULTS AND CONCLUSIONS

The results showed a significant increase of the serum levels of neopterin after 10 d of treatment with glutamine (26.44 +/- 3.08 versus 6.75 +/- 1.73 nmol/L, P < 0.001), thus proving a probable stimulating action carried out by glutamine on the immune system, as testified by the increase of lymphocytes.

摘要

目的

谷氨酰胺是免疫系统关键细胞(特别是淋巴细胞和巨噬细胞)的重要底物,被认为是条件必需氨基酸。一些研究表明,富含谷氨酰胺的全胃肠外营养可改善免疫状态并缩短危重症患者的住院时间。我们研究了补充谷氨酰胺的全胃肠外营养对厌食症患者免疫系统的影响。

方法

36 例厌食症患者随机分为两组,分别接受标准全胃肠外营养或添加 0.18 g/kg·d 的谷氨酰胺的全胃肠外营养治疗 20 d。为了评估免疫系统状态,我们在治疗开始后第 10 和 20 天测定血清中新蝶呤和胰岛素样生长因子-1水平和淋巴细胞计数。

结果和结论

结果显示,治疗 10 d 后补充谷氨酰胺可显著升高血清新蝶呤水平(26.44 ± 3.08 比 6.75 ± 1.73 nmol/L,P < 0.001),这表明谷氨酰胺可能对免疫系统具有刺激作用,这一点可通过淋巴细胞的增加得到证明。

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