谷氨酰胺对非小细胞肺癌患者的营养状况及免疫功能的干预效果

EFFECT OF GLUTAMINE ON NUTRITIONAL STATUS AND IMMUNE FUNCTION IN PATIENTS WITH NON-SMALL CELL LUNG CANCER

目的探讨谷氨酰胺对非小细胞肺癌患者的营养状况及免疫功能的干预效果。方法按照"最小随机化分组方法"将存在营养不良的非小细胞肺癌患者104例,分为观察组和对照组,每组52例,均采用紫杉醇联合顺铂方案化疗。对照组给予常规营养支持治疗,观察组在营养支持治疗基础上联合口服谷氨酰胺10g/次,3次/d,共干预28 d。分别在干预前、干预后对二组患者的营养状况、营养指标及免疫指标进行比较。结果谷氨酰胺干预后,观察组血红蛋白(HB)、总蛋白(TP)、白蛋白(ALB)、前白蛋白(PALB)均高于对照组(P<0.05),患者主观整体评估(PG-SGA)评分显著低于对照组(P<0.01)。谷氨酰胺干预后,观察组CD3^+T淋巴细胞、CD4^+T淋巴细胞圴较干预前升高(均P<0.05),观察组CD8^+T淋巴细胞、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)均高于对照组(均P<0.05)。结论谷氨酰胺能够改善非小细胞肺癌患者的营养状况、免疫功能,尤其是细胞免疫。

Objective To explore the effect of glutamine on nutritional status and immune function in patients with non-small cell lung cancer.Methods According to"minimum randomization method",one hundred and four NSCLC patients with malnutrition were enrolled in the study and divided into the observation groupobservation group and the control group,52 cases in each group,both treated with Paclitaxel and Cisplatin chemotherapy.The control group was given conventional nutritional support treatment,while the observation group was treated with glutamine 10 g each time,three times a day on the basis of nutritional support,both intervened for 28 d.The nutritional status,nutritional index and immune index of the two groups were respectively compared before and after the intervention.Results After glutamine intervention,HB,TP,ALB and PALB of observation group were higher than those of control group(P<0.05)and PG-SGA score of observation group was significantly lower than that of control group(P<0.01).After glutamine intervention,CD3^+and CD4^+of observation group were higher than those before intervention(P<0.05),and CD8^+,IgG and IgA of observation group were higher than those of control group(P<0.05).Conclusion Glutamine can improve the nutritional status of patients with NSCLC and improve their immune function,especially cellular immunity.