肿瘤专用型肠内营养乳剂对胃癌患者营养状况和免疫功能的影响

Effect of supportan on nutritional status and immune function of late-staged gastric cancer patients undergoing chemotherapy

目的研究肿瘤患者专用型肠内营养乳剂supportan对胃癌患者进行化疗时的营养状况和免疫功能的影响。方法将66例胃癌患者分为两组,33例患者在化疗期间采用肿瘤患者专用型肠内营养乳剂(EN组)；另外33例(对照组)给予基本膳食。分别于化疗前及化疗后14 d时测量体重(BW)、血红蛋白(Hb)、总蛋白、白蛋白(ALB)、前白蛋白(PA)和转铁蛋白(TFN)以评价营养状况；并测量自然杀伤细胞(NK)、CD4、CD8、CD4/CD8、白介素(IL)-1α、IL-6和肿瘤坏死因子(TNF-α)以评价免疫功能。结果化疗前后EN组各项营养指标无明显改变。对照组化疗后ALB、TFN、Hb和BW明显降低,与化疗前比较差异有统计学意义(P＜0．05,P＜0．01)。EN组化疗后CD4、CD4/CD8明显升高,而NK、IL-1、IL-6明显降低,与化疗前比较差异有统计学意义(P＜0．05,P＜0．01)。对照组IL-6、TNF-α较化疗前明显升高,差异有统计学意义(P＜0．01)。在化疗不良反应方面,尽管EN组胃肠道反应和骨髓抑制情况较对照组减轻,但差异无统计学意义(P＞0．05)。结论肿瘤患者专用型肠内营养乳剂可以预防化疗后营养不良的发生,改善机体的免疫功能和减轻消化道反应及骨髓抑制。

Objective To evaluate the effect of Supportan, an enteral nutrition （EN） specific for tumor patients, on the nutritional status and immune function of late-staged gastric cancer patients undergoing chemotherapy. Methods Sixty-six late-staged gastric cancer patients undergoing chemotherapy were randomly divided into EN group （ n = 33） and control group （ n = 33）. During chemotherapy, the patients in EN group received Supportan and the patients in the control group received basic diet. On the 14th day before chemotherapy and after chemotherapy, nutritional status and cell immune indicators were evaluated. Results As for nutrition indicators, there were no significant differences in EN group before and after chemotherapy （ P 〉 O. 05）. Total protein, hemoglobin, prealbumin and transferrin significantly decreased after chemotherapy compared with those before chemotherapy in the control group （P 〈0. 01） . The levels of CD4^＋, CD8^＋ T cells and CD4/CD8 were significantly increased, and NK cells, serum levels of IL-1, IL-6 were signifieandy decreased after chemotherapy in EN group （ P 〈 0. 01） . The levels of IL-6 and TNF-α were significantly higher after chemotherapy than those before chemotherapy in the control group（ P 〈 0. 01） . Curative effects of immune nutrition in EN group were superior to that in the control group, however, the differences were not statistically significant. The incidences of nausea, vomiting and marrow inhibition in Supportan group was lower compared with those in the control group, but with no significant difference. Conclusion Supportan can prevent malnutrition of the late-staged gastric cancer patients undergoing chemotherapy, and improve immune function and alleviate adverse effects of chemotherapy.