术前精氨酸强化PN对结直肠癌病人免疫功能的影响

The effect of preoperative total parenteral nutrition enriched with arginine on immune function for patients with colorectal cancer

目的：探讨术前精氨酸强化肠外营养（ＰＮ）对结直肠癌病人免疫功能的影响。方法：选择经病理证实的结直肠癌病人作为研究对象，术前随机分为三组，即对照组给常规术前准备，常规ＰＮ组和精氨酸强化ＰＮ组除常规准备外，分别给予常规ＰＮ和精氨酸强化ＰＮ７天，术前７天和手术当天早晨７：００采集外周静脉血，测定ＣＤ３、ＣＤ４、ＣＤ８、ＩＬ－２、ＮＫ细胞和ＮＫ细胞活性；取同期进行腹股沟疝手术的病人作为正常对照。结果：三组病人入院时均有明显的免疫功能抑制，常规ＰＮ组营养前、后各项免疫指标无显著性差异；而精氨酸强化ＰＮ组则有显著改变。结论：术前常规ＰＮ无助于结直肠癌病人免疫功能抑制的改善；精氨酸强化ＰＮ则有明显的免疫增强作用。

Objectives:To discuss the effect of preopertive TPN enriched with arginine on immune function for patients with colorectal cancer. Methods:All selected patients with colorectal cancer were diagnosed by pathobiology,having normal liver and renal function,without metabolic and immune disease,and no patient accepted radiotherapy,immunetherapy chemotherapy and splenectomy.The patients were divided into three groups randomly:control group,TPN group,and TPN enriched with arginine group.The rountine preoperative preparation was given in control group,in addition that,TPN and arginine enriched TPN were given in other groups for 7 days.The peripheral vein blood was collected in operation day and 7 day before that to calculate the CD3,CD4,CD8,IL 2,NK cell and NK cell activity. Results:All patients had obvious immunodepression at admission.Every object had no significant difference between preoperative and postoperative period in TPN group.It had significant difference in TPN enriched with arginine group. Conclusions:Preoperative TPN has no help in improving immunodepression.TPN enriched with arginine has significant value in promoting immune function,it may improve immunodepression.