直肠癌根治术前应用免疫增强型肠内营养对患者术后免疫应答水平及创伤耐受能力的影响

摘要

目的：：研究直肠癌根治术前应用免疫增强型肠内营养对患者术后免疫应答水平及创伤耐受能力的影响。方法：选择2013年5月~2015年10月期间在我院接受直肠癌根治术的94例患者,随机分为EN 组和对照组,EN 组术前使用免疫增强型肠内营养制剂,对照组术前进行常规营养干预。术后当天,采集外周血单个核细胞并测定 CD69、HLA-DR 的含量,采集血清并测定 IgM、IgG 以及炎症反应指标、应激反应指标的含量。结果：EN 组患者外周血单个核细胞中 CD69、HLA-DR 的含量以及血清中 IgM、IgG、总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TF)含量均显著高于对照组,EN 组患者血清中 C 反应蛋白(CRP)、YKL-40、白介素(IL)-1β、肿瘤坏死因子-α(TNF-α)、IL-6、HSP70、ACTH、Cor、HO-1的含量均显著低于对照组。结论：直肠癌根治术前应用免疫增强型肠内营养能够改善免疫功能和营养状况,增强创伤耐受能力并减轻术后炎症反应和应激反应。%[ABSTRACT]Objective:To study the effect of immune-enhancing enteral nutrition application before radical resection of rectal carcinoma on postoperative immune response level and trauma endurance capacity.Methods:A total of 94 patients who received radical resection of rectal carcinoma in our hospital between May 2013 and October 201 5 were selected and randomly divided into EN group and control group,the EN group received preoperative immune-enhancing enteral nutrition preparations, and the control group received routine preoperative nutrition intervention.The same day after operation,peripheral blood mononuclear cells were collected to determine CD69 and HLA-DR levels,and serum was collected to determine the levels of IgM,IgG,inflammatory response indexes and stress response indexes.Results:CD69 and HLA-DR levels in peripheral blood mononuclear cells as well as IgM,IgG,TP,ALB,PA and TF levels in serum of EN group were significantly higher than those of control group,and serum CRP,YKL-40,IL-1β,TNF-α,IL-6,HSP70,ACTH,Cor and HO-1 levels of EN group were significantly lower than those of control group.Conclusions:Immune-enhancing enteral nutrition application before radical re-section of rectal carcinoma can improve the immune function and nutritional status,strengthen trauma endurance capacity and relieve postoperative inflammatory response and stress response.