| ObjectiveTo investigate the malnutrition and impaired immune function status in childrenwith AIDS, to observe the effects of the glutamine-enriched enteral nutritionintervention on nutrition, lymphocyte immune function and other indicators inchildren with AIDS, and to discuss the role of enhancing enteral nutritional supporton improvement of the nutrition status and immune function in children with AIDSand to provide scientific basis for the development of comprehensive treatment andnutrition support scheme in children with AIDS.MethodsThe randomized, controlled clinical trials was used. The inclusion criteria werethe cases who met the diagnostic criteria for AIDS children aged between3to15years old. The58cases AIDS children who met the criteria were randomly assignedto intervention and control groups, including30and28children3-15years old of age,respectively. The cases in control group were given conventional enteral nutritionsupport according to the reccommended reference intake of children and adolescentson protein, calories.The cases in treatment group were given the diet with addingglutamine0.3g//kg·d by oral or tube feeding. on the basis of diet in control group.The height, weight,triceps skin-fold thickness and other indicators of the AIDSchildren were measured before and after28d nutritional intervention. The fastingblood samples in the same day morning were collected to detect the levels of theserum glutamine, serum albumin, prealbumin and heamoglobin, peripheral bloodtotal lymphocyte counts and CD3+, CD4+,CD8+cell counts, CD4+/CD8+ratio. Thedifferences of the indicators were compared between the two groups. All data were analysed by using the SPSS12.0. The results were expressed withx±s. T-test was used to comparae between two groups. The enumeration data wereanalyzed by chi-square test, a=0.05.Results1.The changes of nutrition indexesThe nutrition indexes of the children were no significant difference(P>0.05)between the treatment group and the control group before the nutritionintervention. The weight, body mass index of the children in treatment groupincreased significantly after intervention (P<0.05). The serum albumin, prealbuminand hemoglobin of the children also increased significantly in the treatment groupcompared with the control group after intervention, the difference was statisticallysignificant (P﹤0.01).2. The changes of cellular immune indexesThe immune indexes of children were no statistically significant difference (P﹥0.05) between the treatment group and the control group before the intervention.After taking a different formula of enterral nutrition intervention, the TLC, CD4+andCD4+/CD8+ratio of children in the treatment group increased significantly comparedwith those in the control group (P<0.05or P<0.01).3. The changes of serum glutamine concentrationThe serum glutamine concentration of the children in the treatment group was nostatistically significant difference(P﹥0.05) compared with the control group beforethe intervention. After nutritional intervention, the serum glutamine levels of childrenin the treatment group increased significantly compared with the control group, thedifference between two groups was statistically significant difference (P<0.05).4. The gastrointestinal complicationsDuring the implementation of enteral nutrition support, the childrens between two groups appeared varied degrees of gastrointestinal reactions. The symptomsdisappeared after symptomatic treatment. The incidence of gastrointestinal reactionsin the treatment group was lower than that of in the control group(16.7%vs32.1%),the difference was statistically significant(P﹤0.05).5. The changes of recently clinical outcomesCompared with the control group, the in-patient time of the children in thetreatment group has significantly shorter, the difference was statistically significan(P﹤0.05）. The new infection incidence was32.1%in the control group, which was16.7%in the treatment group. It was statistically significant(P﹤0.01). between them..ConclusionsApplication of the glutamine strengthening enteral nutrition intervention onchildren with AIDS could effectively maintain and increase the serum concentrationof glutamine, improve the nutritional status, raise the lymphocyte immune function ofthe children with AIDS, reduce the gastrointestinal complications, reduce newinfections, shorten the hospitalization time. It had a positive effect for improving theprognosis of children with AIDS, had good clinical application value to promote anddeserved further study. |
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