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    瓜氨酸对重症病人急性胃肠功能障碍的评估价值

    Evaluation value of citrulline in severe patients with acute gastrointestinal dysfunction

      摘要
    • 摘要:
      目的探讨瓜氨酸对重症病人急性胃肠功能障碍的评估价值。
      方法采用前瞻性研究方法，选择ICU及EICU的重症病人113例，根据是否发生急性胃肠损伤(AGI)分为AGI组(n=73)和非AGI组(n=40)，统计分析2组病人的血清瓜氨酸水平，并分析AGI组病人的急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)、多器官功能障碍综合征(MODS)评分、28 d死亡率，然后分析其相关性。
      结果AGI组不同临床分级病人第3天的血清瓜氨酸水平均低于第1天(P < 0.05)；第1天、第3天的血清瓜氨酸水平，AGI组Ⅰ级病人高于Ⅱ级和Ⅲ级，Ⅱ级和Ⅲ级病人高于Ⅳ级，差异均有统计学意义(P < 0.01)；AGI组各分级病人均低于非AGI组(P < 0.01)。AGI组Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级病人的MODS评分和28 d死亡率均逐渐升高(P < 0.01)，APACHEⅡ评分Ⅰ级病人低于Ⅱ级、Ⅲ级和Ⅳ级(P < 0.05~ P < 0.01)。AGI组病人的血清瓜氨酸水平与临床分级(rs=-0.731)、APACHEⅡ评分(r=-0.573)、MODS评分(r=-0.611)均呈显著负相关关系(P < 0.01)。
      结论瓜氨酸对重症病人急性胃肠功能障碍有较高的评估价值。

       

      Abstract:
      ObjectiveTo investigate the value of citrulline on acute gastrointestinal dysfunction in severe patients.
      MethodsA prospective study was used to select 113 cases of severe patients admitted to ICU and EICU.According to the occurrence of acute gastrointestinal injury (AGI), they were divided into AGI group(n=73) and non-AGI group(n=40).The serum citrulline levels of the two groups were statistically analyzed.The APACHE Ⅱ score, MODS score and 28 days mortality of the AGI group were statistically analyzed, then the correlation was analyzed.
      ResultsThe serum citrulline level of AGI patients with different clinical grades on the third day was lower than that on the first day (P < 0.05).The serum citrulline level on the first and third days of grade Ⅰ patients in AGI group was higher than that in grade Ⅱ and Ⅲ patients, and that in grade Ⅱ and Ⅲ patients was higher than that in grade Ⅳ patients, the difference was statistically significant (P < 0.01).All patients in AGI group were lower than those in non-AGI group (P < 0.01).In AGI group, the MODS scores and 28 day mortality of patients with grade Ⅰ, Ⅱ, Ⅲ and Ⅳ were gradually increased (P < 0.01), and the APACHE Ⅱ score of patients with grade Ⅰ was lower than those with grade Ⅱ, Ⅲ and Ⅳ (P < 0.05 to P < 0.01).The serum citrulline level in AGI group was significantly negatively correlated with clinical grade (rs=-0.731), APACHE Ⅱ score(r=-0.573) and MODS score(r=-0.611) (P < 0.01).
      ConclusionsCitrulline has high evaluation value for acute gastrointestinal dysfunction in severe patients.

       

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