谷氨酰胺对胃肠道肿瘤患者术后免疫功能的影响

Effect of glutamine enhanced PN on postoperative immune function in patients with gastrointestinal cancer

目的 :观察谷氨酰胺 (Gln)对胃肠道肿瘤患者术后免疫功能的影响。方法 :胃肠道肿瘤患者 4 0例 ,分为研究组 (n =2 0 )和对照组 (n =2 0 ) ,两组由术后第 1天开始连续给予肠外营养 7d。两组肠外营养能量按 10 4kJ·kg-1·d-1供给 ,氮入量为 0 .2g·kg-1·d-1。研究组由 2 0 %L 丙氨酰 L 谷氨酰胺双肽注射液 0 .5g·kg-1·d-1,余氮量由 8.5 %乐凡命供给。对照组仅用 8.5 %乐凡命为氮源 ,分别抽取术前、术后第 1天、术后第8天的静脉血 ,测定比较血清Gln、白蛋白、NK细胞、IL 6、TNF α水平。结果 :研究组Gln、白蛋白、NK细胞水平在术后第 8天明显高于对照组 ,而IL 6、TNF α水平明显低于对照组。结论 :补充Gln能提高胃肠道肿瘤患者的细胞免疫功能 ,维持细胞因子之间的相对平衡 ,增强NK细胞活性 ,对胃肠道肿瘤患者的术后康复具有重要意义。

Objective:To observet the effects of glutamine enhanced PN on postoperative inflammatory and immune function in patients with gastrointestinal cancer.Methods:Forty randomly chosen patients with gastrointestinal cancer were enrolled in this study, who received either glutamine enhanced PN or isocaloric and isonitrogenous standard PN for 7 d from the first day after the day of surgical removal of the tumors. Tests of the immune function included natural killer cells, interleukin-6, TNF-α and plasma levels of glutamine,albumin were performed preoperatively and on postoperative day 1 and 8.Results:Plasma levels of glutamine,albumin natural killer cells were higher in glutamine enhanced PN group,and IL-6 and TNF-α were lower in the research group on postoperative day 8 (P<0.05). Data analysis demonstrated the immune condition was improved in glutamine enhanced PN group compared with the results in the analysis control group.Conclusion:Glutamine enhanced PN can improve the immune function in patients with gastrointestinal cancer after operation.