Effect Of Glutamine On Patients With Chronic Obstructive Pulmonary Disease Accompanied By Respiratory Failure

Objective: To evaluate the effect of alanyl-glutamine (Aln-Gln) on patients with chronic obstructive pulmonary disease (COPD) accompanied by respiratory failure. Methods: Thirty malnutritional patients with COPD accompanied by respiratory failure, who were adopted mechanical ventilation therapy, were randomly divided into two groups: Gln group and control group(15 cases in each group). Both groups were received standard enteral nutrition, the daily dietary calories consumption was 126～147KJ/ Kg·d^-1, including nitrogen 0.2g/Kg·d^-1. Gln group at same time supplemented intravenous Aln-Gln 0.4g/Kg·d^-1, instead of 20g protein. The anthropometry, immune and biochemical indices were measured before nutrition treatment and 7th, 14th, 21th, 28th day after nutrition treatment. Results: (1) The anthropometry and biochemical indices such as prealbumin (PALB), retinol binding protein (RBP), transferrin(TFN), and blood serum albumin (ALB) in Gln group were significantly increased (P＜0.05), and there was significant difference between Gln group and control group at PALB and RBP(P＜0.01). There was no significant difference of AMC and TSF between pro-treatment and post- treatment in Gin group and control group. The difference of AMC and TSF in post-treatment between Gln group and control group was not found (P＞0.05). (2) Immune indices such as total lymphocyte count (TLC), T lymphocyte (CD3), helper lymphocyte T (CD4), CD4/CD8, immune globulin IgA, IgG were significantly increased after four weeks treatment in Gin group (P＜0.05). But in control group, no significant difference was found except blood TLC. (3)The indices of pro-treatment compared with that of post-treatment in every measured time. We found there was significant difference in Gln group except AMC and TSF (P＞0.05) and there was no significant difference in control group except TLC, RBP, PALB at 21th and 28th. (4) After four weeks treatment, arterial partial pressure of oxygen(PaO₂) and arterial partial pressure of carbon dioxide(PaCO₂) on Gln group and control group were significantly improved(P＜0.05), but there was no significant difference between Gln group and control group (P＞0.05). Conclusion: Alanyl-glutamine improved nutritional supporting and lymphocyte immune functions, and was benefit to the COPD patient accompanied by respiratory failure.