谷氨酰胺增强的胃肠外营养对结直肠癌患者术后免疫功能的影响

Glutamine enhanced PN on the effect of postoperative immunologic function in patients with colorectal cancer

目的 探讨谷氨酰胺增强的胃肠外营养对结直肠癌患者术后免疫功能的影响。方法 随机选择在南方医院普外科住院治疗的40例结直肠癌患者,术后分别接受等氮、等热量常规肠外营养支持或谷氨酰胺增强的肠外营养支持(0.30～0.40g·kg^(-1)·d^(-1))1周,检测术前、术后不同时期的免疫功能包括CD3^+、CD4^+、CD8^+、CD4^+/CD8^+比值,IL-2R、NK、C3、C4、CH50、IgG、IgA、IgM及其他指标。结果 经方差分析,二组患者入院均有明显的免疫抑制,谷氨酰胺增强的肠外营养组患者的免疫功能(CD4^+、CD4^+/CD8^+、NK、IL-2R)在术后第4、7天与对照组相比有明显改善(P<O.05)。结论 谷氨酰胺能改善大肠癌患者术后的免疫功能,能增进肠外营养的效果。

Objective To study glutamine enhanced PN on the effect of postoperative immunologic function in patients with colorectal cancer. Methods Forty patients received either Standard PN or PN supplemented with 0. 3 g-0. 4 g ·kg-1 ·d-1 Gluatmine for 7 days after colorectal cancer operation. Nitrogen and calories were similar between two groups. Immunologic function (CD 3 + , CD 4 + , CD 8 + , CD 4 + /CD 8 + , IL2R, NK, C3, C4, CH50, IgA, IgM, IgE) were tested during preopertion and postoperation. Results ANOVA indicated that both groups had immunosupression before operation. Compared study group with control group, the immunologic function in the for-mer had been obviously improved at the 4 th day and the 7 th day after operation (P < 0. 05) . Conclusion Glutamine can improve the immunologic function in the patients with colorectal cancer after operation and enhance the effect of parenteral nutrition.