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目的 比较丙氨酰谷氨酰胺(Alanyl-glutamine,Ala-Gln)强化早期肠内营养(enhanced early enteral nutrition,EEN)应用于维吾尔族和汉族重型颅脑损伤患者营养支持的效果.方法 重型颅脑损伤患者,32名维吾尔族和40名汉族,随机分为对照组和实验组.对照组在常规治疗基础上进行EEN,实验组在对照组的基础上加用Ala-Gln注射液0.5 g·kg-1·d-1,治疗10 d.入院第1、3、7天进行胃肠功能评分;入院第1天、第10天采血检测总蛋白质(total protein,TP)、血清白蛋白(serum albumin,ALB)、血红蛋白(hemoglobin,Hb),同时测量肱三头肌皮皱厚度、臂肌围指数,并观察并发症发生情况.结果 四组患者入院第3、5、7天胃肠功能均进行性恢复,两个实验组的恢复均优于两个对照组,第5、7天维吾尔族实验组的恢复优于汉族实验组(均P<0.05).除维吾尔族实验组外,其余各组入院第10天的TP均显著低于入院第1天.两个对照组入院第10天的ALB均显著低于入院第1天,维吾尔族实验组入院第10天的ALB显著高于维吾尔族对照组和汉族实验组(均P<0.05).各组不同时间点的Hb间均差异无统计学意义.两个实验组入院第10天的肱三头肌皮皱厚度均显著大于入院第1天,其中维吾尔族实验组入院第10天的肱三头肌皮皱厚度显著大于汉族实验组(P<0.05).臂肌围指数各组间相比均差异无统计学意义.汉族和维吾尔族实验组发生并发症的比例显著低于相应的对照组(均P<0.05),维吾尔族实验组消化道出血和肺部感染发生率显著低于汉族实验组.维吾尔族患者肺部感染发生率显著低于汉族(P<0.05).结论 Ala-Gln强化EEN能改善重度颅脑损伤患者的胃肠功能,促进蛋白质的合成,改善营养状况,减少感染的发生,可用于重型颅脑损伤患者的治疗,且维吾尔族患者病情恢复效果更为显著.“,”Objective To compare the clinical effects of alanyl-glutamine(Ala-Gln)enhanced early enteral nutrition (EEN) in treatment of severe craniocerebral injury in patients of Han and Uygur nationalities. Methods 34 patients with severe craniocerebral injuries, 15 of Uygur nationality, and 19 of Han nationality, underewent conventional treatment, including mechanical ventilation, mild hypothermia therapy, dehydration by mannitol, maintenance of cerebral perfusion pressure, EEN,etc.(Uygur and Han Control Groups);and 36 patients with severe craniocerebral injuries, 17 of Uygur nationality, and 21 of Han nationality, were treated with 0.5 g·kg-1·d-1Ala-Gln injection in addition to the above-mentioned conventional treatment(Uygur and Han Experiment Groups).All groups were treated for 10 days.Gastrointestinal function score was evaluated on the first,third and seventh hospitalization days.On the first and tenth hospitalization days peripheral blood samples were collected to examinae the levels of total protein(TP),serum albumin(ALB),and hemoglobin(Hb),and triceps skinfold thickness and arm muscle circumference index were measured. Related complications were observed. Results The gastrointestinal function scores on the third, fifth, and seventh hospitalization days of the 4 groups all showed progressive increase(all P<0.05); the scores on the 3rd,5th, and 7th days of the 2 experiment groups were all higher than those of the correspondent control groups; and the scores on the 5th and 7th days of the Uighur Experiment Group were all significantly higher than those of the correspondent Han Experiment Group(both P<0.05). Except for the Uygur Experiment Group,the TP levels of all the other groups on the 10th hospitalization day were all significantly lower than those on the 1st hospitalization day(all P<0.05); the ALB levels of the 2 control groups on the 10th hospitalization day were both significantly lower than those on the first hospitalization day(both P< 0.05); no significant difference was seen in the ALB level between the 2 experiment groups on the first and tenth hospitalization days; the ALB level on the tenth hospitalization day of Uygur Experiment Group was significantly higher than those of Uygur Control Group and Han Experiment Group (all P0.05).The triceps skinfold thickness values of the 2 experiment groups on the tenth hospitalization day were significantly higher than those on the first hospitalization day,and the triceps skinfold thickness value of Uygur Experiment Group was significantly higher than that of Han Experiment Group(all P0.05). The incidence rates of complications of Han and Uygur Experiment Groups were both significantly lower than those of the corresponding control groups(all P<0.05); and the incidence rates of gastrointestinal bleeding and pulmonary infection of Uygur Experiment Group were significantly lower than those of Han Experiment Group(P<0.05).Conclusion Ala-Gln-enriched EEN improves the gastrointestinal functions,protein synthesis and nutritional status of the patients,of Han and Uygur nationalities,with severe craniocerebral injury, and reduces the incidence of infections.Such a treatment is especially effective in Uygur patients.