肠内营养对消化系统肿瘤患者术后血清非谷氨酰胺氨基酸谱的影响

Effects of Enteral Nutrition on Serum Non-glutamine Amino-acids Pattern of Patients Following Surgery for Tumors of Digestive System

目的:比较肠内营养与肠外营养对消化道肿瘤病人术后血清非谷氨酰胺氨基酸谱的影响。方法:将40例消化系统肿瘤患者随机分为肠内营养(EN)组和肠外营养(PN)组,每组20例,试验周期为7d。术后第1天开始给予等热量、等氮量的营养支持1周。检测术前和术后第8天患者的血清非谷氨酰胺氨基酸谱。结果:EN组能明显提高血清天门冬氨酸(ASP)、丝氨酸(SER)、谷氨酸(GLU)、半胱氨酸(CYS)、异亮氨酸(ILE)及苯丙氨酸(PHE)的水平,而PN组经过营养支持后,血清蛋氨酸(MET)水平升高,组氨酸(HIS)水平下降。结论:在消化道肿瘤患者术后早期应激状态下,肠内营养较肠外营养可更好地维持血清氨基酸水平,甚至明显升高部分氨基酸的浓度,包括天门冬氨酸(ASP)、丝氨酸(SER)、谷氨酸(GLU)、半胱氨酸(CYS)、异亮氨酸(ILE)及苯丙氨酸(PHE)。

Objective;To evaluate the effects of enteral nutrition（EN） and parenteral nutrition（PN） on serum non-glutamine amino-acids pattern of patients following surgery for tumors of digestive system. Methods：40 patients who underwent surgery for gastroenteric tumors were randomized to EN group （n = 20） or PN group （n = 20） for 7 days. Isoealoric and isonitrogenous nutritional supports began at the first day after operation and were maintained for a week. Serum aminocids pattern was measured preoperatively and on the 8th day after operation. Results： In EN group, the levels of aspartie acid（ASP）, serine（SER）, glutamie aeid（GLU）, eysteine（CYS）, isoleueine（ILE） and phenylalanine（PHE） were increased significantly. A rise of methionine（MET） and a decrease of histidine（His） were showed in PN group. Conclusion： In the state of stress after surgery for tumors of digestive system, EN offers better support on serum amino-acids, even increases levels of some amino-acids significantly, such as ASP, SER, GLU, CYS, ILE and PHE.