摘要
目的:观察联合应用精氨酸(Arg)和谷氨酰胺(Glu)强化的肠外营养(PN)对结肠癌患者术后应激及免疫状态的影响.方法:60例手术治疗的结肠癌患者,随机分为实验组和常规组(标准PN组),每组30例,营养支持疗程为7d.采用全营养混合液通过周围或中心静脉输注,均为等氮等热量.30例同期行择期腹部手术的患者(胆结石17例、阑尾炎13例)作为对照组.于术前第1日、术后第1日、第7日抽静脉血,观察结肠癌与对照组术前及实验组与常规组患者不同时期的应激状态(C3,C4,CRP)和免疫功能(CD4+,CD8+,CD4+/CD8+,IgG,IgM)的变化.结果:术前结肠癌患者的C3,C4及CRP高于对照组(P<0.05),术后第7日实验组较常规组有改善(P<0.05).结肠癌患者入院时均有明显的免疫抑制,实验组(CD4+,CD8+,CD4+/CD8+,IgG,IgM)在术后第7日与常规组相比有改善(P<0.05).结论:精氨酸和谷氨酰胺强化的肠外营养能有效地改善结肠癌术后患者的应激和免疫状态.
AIM： To evaluate the effect of arginine（Arg） and glutamine（Glu） enriched parenteral nutrition （ PN ） on stress status and immune function after operation of colon cancer patients. METHODS： Sixty patients with colon cancer were randomized into experimental group and routine group （ standard PN group）. From the first day after operation, total PN was infused to the patients with equal calorie and equal nitrogen by central or peripheral vein for 7 days. Thirty patients receiving operation for gallstone （ n = 17 ） and appendicitis （ n = 13 ） were chosen as controls. Tests of the stress status（ C3, CA and CRP） and immune function （ CD4^＋ , CD8^＋, CD4^＋/CD8^＋ , IgG and IgM ） were performed preoperatively and at different time points postoperatively. RESULTS： In cancer patients, the C3, CA and CRP were higher than those in control group （ P 〈 0.05 ）. The data of experiment group were ameliorated compared with routine group at the 1 st day and the 7th day after operation（ P 〈 0.05 ）. Experimental group and routine group had immune suppression before operation. Experimental group had improved immune function with increased CD4^＋, CD8^＋, CD4^＋/CD8^＋, IgG and IgM as compared with routine group at the 1st and the 7th day after operation （P 〈 0.05）. CONCLUSION： Arg and Glu enriched PN could effectively ameliorate the stress status and immune function after operation of colon cancer patients.
出处
《第四军医大学学报》
北大核心
2008年第2期178-180,共3页
Journal of the Fourth Military Medical University
关键词
结肠肿瘤
精氨酸
谷氨酰胺
胃肠外营养
应激
免疫功能
colonic neoplasms
arginine
glutamine
parenteral nutrition
stress
immune function
作者简介
张长安．学士，主治医师．Tel：（0913）8213919Email：fpzca@163．com
