术前静脉营养支持在胃癌治疗中的作用

Use of parenteral nutritional support in patients withgastric cancer:The relationship of protein turn over,immunocompetence and tumor cell kinetics

作者对进展期胃癌患者进行了一系列前瞻性研究，探索静脉营养支持与蛋白质代谢、机体免疫功能和肿瘤生长之间的关系。结果提示：静脉营养支持可促进整体蛋白质更新率和合成率的增加，表现为正氮平衡；同时可见血浆转铁蛋白和前白蛋白水平较前提高。营养支持后，ＮＫ细胞活性和Ｔ淋巴细胞总数增加，尤其的增加具统计学意义（Ｐ＜０．０５）。但肿瘤细胞在营养支持后，Ｇ＿０／Ｇ＿１的百分率明显下降（Ｐ＜０．０１），增殖期细胞百分比上升（Ｐ＜０．０５）；正常胃粘膜细胞则未见类似变化。故认为：尽管术前应用静脉营养支持可能刺激肿瘤生长，但就整体而言，利大于弊，术前短期应用，尤适用于那些伴营养不良、术后发生并发症可能世较大的患者。

AbstractIn order to elucidate the effect of preoperative par-enteral nutritional support(PNS)on proteinmetabolism,host immunocompetence and tumor cellkinetics,two prospective trials were made in patientswith gastric cancer, All the patients were given PNSfor 7 davs in addition to oral intake。 The positive ni-trogen balance and increase of protein anabolic rate wasgreater in PNS groups than in control group.Therewas a moderate increase in NKC after PNS.The rise inwas significant (P<0.05).The percentage of G_0/G_1 cells fell after PNS (P<0. 01 ),while that of thewhole proliferative phase(S + G_2+M)rose(P <0. 05).These changes were not noted in normal gastricmucosa。In conclusion,despite of stimulating tumorcell proliferation, PNS helps to promote whole bodyprotein synthesis and to amelio-rate the immunocompe-tence of advanced gastric cancer patients before opera-tion。