TPN添加丙氨酰谷氨酰胺在高龄胃癌患者术后治疗的应用

Effect of alanyl-glutamin-supplemented total parenteral nutrition on aged patients with gastric cancer

目的观察全肠外营养(TPN)添加丙氨酰谷氨酰胺对高龄胃癌术后患者营养、免疫功能影响。方法高龄胃癌术后患者72例,随机分为对照组和研究组,对照组采用常规TPN,研究组在常规TPN基础上加用丙氨酰谷氨酰胺注射液。于术前及术后第3天、第8天分别抽取外周血测定IgG、IgA、IgM和T淋巴细胞亚群CD3、CD4、CD8,及CD4/CD8比值,及TP、ALB指标。结果术后第8天,研究组患者的IgG、IgA和IgM明显回升并高于术前水平,CD3、CD4和CD4/CD8比值与对照组有显著性差异(P<0.05),而TP、ALB指标明显高于对照组。结论TPN添加丙氨酰谷氨酰胺能有效改善和增强高龄胃癌患者术后免疫功能及营养水平。

Objective To investigate the effect of alanyl- glutamine supplemented total parenteral nutrition （TPN） on immunefunction and postoperative nutrition of patients with gastric cancer. Methods Seventy - two aged gastric cancer patients with gastrectomy were randomly divided into thecontrol group （n = 36） and experiment group （n = 36）. Patients in the control group received conventional TPN support, and patients in the experiment group received TPN support and alanyl-glutamine （0.50 g/kg）. The levels of IgG, IgA, IgM, CD3, CD4, CD8 ,CD4/CD8 ,TP and ALB were measured before operation and on third and eighth day after operation. Results The levels of IgG, IgA, IgM, CD3, CD4 , CD4/CD8, TP and ALB were significantly different between two groups on eighth day after operation （ P 〈 0.05 ）. Conclusions TPN supplemented with alanyl - glutamine can improve the immunefunction and postoperative nutrition of aged patients with gastric cancer radical gastrectomy.