特定肠内营养对胃癌术后免疫功能的影响

Effect of Special Enteral Nutrition Support on Postoperative Immune Function of Patients with Gastric Cancer

目的探讨免疫肠内营养支持对胃癌患者术后免疫功能的影响。方法将48例进展期胃癌根治术患者随机分成对照组(n=20)、实验A组(n=15)和实验B组(n=13)。对照组为普通输液组;实验A组为标准肠内营养组,采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,采用免疫增强型肠内营养混悬液。实验组术后第2天起给予肠内营养(104.5 kJ.kg-1.d-1),持续7 d,进行临床观察及血浆谷胱甘肽(GSH)含量和免疫指标的检测。结果除对照组2例出现肺部感染外,其余患者均未发生严重并发症。术后第7天与术前相比,实验B组患者血浆GSH浓度明显上升(P<0.05);各组IgG、IgM、IgA、CD8+、CD4/CD8均无明显改变(P>0.05);实验B组CD4+显著上升,明显高于对照组(P<0.05)。结论早期特殊免疫增强营养支持能有效提高GSH水平,增加CD4+细胞比例。

tions were made preoperatively and 7 d postoperatively. Results Except for two cases of lung infection in the control group, there was no serious complication in the experimental groups. Compared with the day before operation,plasma GSH of experimental group B increased obviously （P 〈 0.05）. The levels of serum IgG, IgM, IgA, CD8^＋ and CD4/CD8 did not change significantly in the control and experimental groups （P 〉 0. 05）. CD4^＋ cells of experimental group B were increased significantly after operation as compared with the control group （P 〈 0.05）. Conclusion Early special immune enhancive nutrition can raise GSH level effectively and increase the proportion of CD4^＋ cells significantly.