谷胱甘肽支持对老年胃癌患者围手术期氨基酸谱变化的影响

Effect of Glutathione Support on Changes of Perioperative Amino Acids Profile in Patients with Gastric Cancer

目的评定谷胱甘肽(GSH)支持对老年胃癌患者围手术期氨基酸谱变化的影响。方法将42例进展期胃癌根治术患者随机分成对照组(n=13)、实验A组(n=14)和实验B组(n=15)。对照组为普通输液组; 实验A组为标准营养组,用整蛋白纤维型肠内营养混悬液;实验B组为免疫增强营养组,采用肠内营养混悬液。实验组术后第2天起给予肠内营养104．5 kJ／(kg·d),连续7天,分别测定血浆GSH和血清氨基酸浓度,观察临床转归。结果除对照组出现2例肺部感染外,其余均未发生严重并发症。与术前相比,术后第7天实验B组患者血浆 GSH浓度明显上升(P=0．035),与对照组(P=0．020)、实验A组(P=0．011)差异有显著性;同时实验B组患者血清丝氨酸(P=0．023)、精氨酸(P=0．031)、缬氨酸(P=0．018)、赖氨酸(P=0．034)和蛋氨酸(P=0．030) 均有明显升高。结论早期特殊免疫增强营养支持能有效提高GSH水平,同时显著增加体内必需氨基酸和半必需氨基酸浓度,改善机体免疫功能。

Objective To evaluate the effect of glutathione （GSH） support on the changes of perioperational serum amino acids profile in patients with gastric cancer. Methods Forty-two patients were randomly divided into control group （n = 13）, group A （Nutrison, n = 14）, and group B （Stresson, n = 15）. The plasma GSH level and the serum amino acids profile were determined 7 days before and after enteral nutrition support [104.5 kJ/（kg. d）]. Results No serious complications were observed in all groups except 2 eases of lung infections in control group. Plasma GSH was remarkedly increased in group B after 7 days of treatment （P = 0.035, compared with the baseline）, which was significantly different from control group （P = 0.020） and group A （P = 0.011）. The levels of serine（P = 0.023）, arginine （P = 0.031 ） ,valine （P = 0.018）, lysine （P = 0.034）, and methionine （P = 0.030） also increased significantly. Conclusion Early special immune-enhancing nutrition support can effectively raise the level of GSH, significantly increase the levels of essential amino acids and semi-essential amino acids, and improve the immune functions of human body.