【摘要】 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。更多还原

【Abstract】 Objective To study the effect of L-glutamine(Gln)on allogeneic peripheral blood stem cell transplantation(allo-PBSCT).Methods A total of thirty six patients receiving allo-PBSCT for hematologic malignancies between 2001 and 2006 in Henan Tumor Hospital were divided into two groups:the group of standard total parenteral nutrition(standard group,n=13)and the group of standard total parenteral nutrition with Gln(Gln group,n=23).Parenteral nutrition was initiated at the day after peripheral blood stem cell transplantation(day 1).Results Nutrient intake was similar in both groups.The time to reach >0.5×109/L neutrophils was(13.2±3.1)days in the standard group,and(13.7±3.5)days in the Gln group(P>0.05).Six patients(6/23)in the Gln group developed mucositis and 11 cases(11/11)in the standard group(P<0.05).One patients(1/23)in the Gln group developed severe diarrhea and 5 cases(5/11)in the standard group(P<0.05).Seven patient(6/11)in the standard group developed clinical infection,however,3 cases(3/23)in the Gln group did it(P<0.05).The time of antibiotic requirements was(15.9±2.6)days in the standard group and(12.4±2.5)days in the Gln group(P<0.05).Free-germ ward stay was shortened in the Gln group[(29.9±1.4)days vs(33.2±2.6)days,P<0.05].Conclusion There is no difference in the time to neutrophil engraftment between the two groups.L-glutamine can diminish the incidence of mucositis and severe diarrhea,and the rates of clinical infection.L-glutamine can also shorten free-germ ward stay and antibiotic requirements.更多还原