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目的研究谷氨酰胺双肽(Gln)在异基因外周血造血干细胞移植(allo-PBSCT)中的作用。方法选取2001—2006年河南省肿瘤医院进行allo-PBSCT的血液系统肿瘤患者36例,随机分为标准化全胃肠外营养液组(标准组,n=13)和加用Gln的全胃肠外营养液组(Gln组,n=23),造血干细胞输注后第1天开始给予全胃肠外营养。结果两组患者营养物质的摄入基本相同,标准组中性粒细胞(ANC)≥0.5×109/L的时间为(13.2±3.1)d,Gln组为(13.7±3.5)d(P>0.05);Gln组有6例发生黏膜炎,标准组为11例(P<0.05);Gln组1例发生严重腹泻,标准组有5例(P<0.05);Gln组有3例发生临床感染,标准组有7例(P<0.05);Gln组抗生素治疗时间为(12.4±2.5)d,标准组为(15.9±2.6)d(P<0.05);Gln组住无菌病房时间缩短[(29.9±1.4)d对(33.2±2.6)d,P<0.05)]。结论两组患者中性粒细胞移植成功的时间差异无显著性意义,但Gln能减少黏膜炎、严重腹泻、临床感染的发生率,缩短抗生素治疗时间及住无菌病房的时间。
Objective To investigate the role of glutamine dipeptide (Gln) in allogeneic peripheral blood stem cell transplantation (allo-PBSCT). Methods Totally 36 patients with hematologic malignancies who underwent allo-PBSCT from 2001 to 2006 in Henan Tumor Hospital were randomly divided into standardized total parenteral nutrition group (n = 13) and Gln plus total parenteral nutrition Nutritional fluid group (Gln group, n = 23). Total parenteral nutrition was given on the first day after hematopoietic stem cell infusion. Results The intake of nutrients in the two groups was basically the same, the time of the group of standard neutrophil (ANC) ≥0.5 × 109 / L was (13.2 ± 3.1) days and that of the group of Gln was (13.7 ± 3.5) days (P> 0.05 ). In the Gln group, 6 patients developed mucositis and 11 patients in the standard group (P <0.05). One patient in the Gln group developed severe diarrhea with 5 patients in the standard group (P <0.05), 3 patients in the Gln group developed clinical infection, The antibiotic treatment time was (12.4 ± 2.5) days in the Gln group and (15.9 ± 2.6) days in the standard group (P <0.05) ± 1.4) d vs (33.2 ± 2.6) d, P <0.05)]. Conclusion There was no significant difference in the successful time of neutrophil transplantation between the two groups, but Gln reduced the incidence of mucositis, severe diarrhea and clinical infection, shorten the duration of antibiotic treatment and stay in sterile ward.