免疫增强型肠内营养对胃癌根治病人术后免疫功能和炎症反应的影响

摘要

Objective To evaluate the effect of postoperative immune-enhanced enteral nutrition on host immune function and inflammatory responses in gastric cancer patients with radical gastrectomy .Methods 42 gastric cancer patients were randomized to study and control group ,each group have 21 patients .Enteral nutrition were stated 1days after surgery and continued for 8 days .Using immune enhanced nutrition ,containing glutamine 、 arginine 、 ε-3 polyunsaturated fatty acids ,and Nutrison Fibre in the study and control group respectively .① T- lymphocyte subsets (CD4 ,CD8 ,CD4/CD8 ) ,immunoglobulin (IgG ,IgM ,IgA ) and ② tumor necrosis factor (TNF-α) ,serum cytokines interleukin (IL-6) were investigated in 1th day preoperative and 1th 、 9th day postoperative .Results Study Group IgA ,CD4 level and CD4/CD8 were significantly higher ( P＜0.05 ) .Inflammatory response indicators ,the Study Group IL-6 ,TNF-α was significantly lower than the control group ( P＜0.05 ).Conclusion immune-enhancd enteral nutrition can alleviate the postoperative inflammatory response and improve immune function in in gastric cancer patients with radical gastrectomy .%目的 观察术后免疫增强型肠内营养对胃癌根治病人术后免疫功能及炎症反应的影响.方法 胃癌根治病人42例,随机分为研究组、对照组,各21例.于术后1-8 d,研究组使用含谷氨酰胺、精氨酸、ω-3多不饱和脂肪酸的免疫增强型肠内营养制剂,对照组使用常规的制剂能全力.观察术前1 d、术后1 d和术后9 d;①T淋巴细胞亚群(CD4、CD8、CD4/CD8)、免疫球蛋白(IgG、IgM、IgA);②肿瘤坏死因子(TNF-α)、血清中细胞因子白介素(IL-6).结果 研究组IgA、CD4水平及CD4/CD8显著高于对照组(P＜0.05).炎症反应指标,研究组IL-6、TNF-α显著低于对照组(P＜0.05).结论 免疫增强型肠内营养可减轻胃癌根治病人术后的机体炎症反应,改善免疫功能.