谷氨酰胺和精氨酸配合放疗对肺癌病人免疫和临床影响的相关研究

Research of glutamine and arginine on immunity and clinical effect for patients of lung cancer radiotherapy

目的:研究谷氨酰胺(Gln)和精氨酸(Arg)配合放疗对肺癌病人营养状况的影响和机体免疫功能的变化。方法:收集临床确诊为非小细胞肺癌病人36例,随机分为单独放疗组(n=18例)和联合治疗组(n=18例)。单独放疗组病人行单独放疗,联合治疗组病人在放疗同时的第1～10天,静脉给予Gln和Arg。所有病人在放疗期间饮食由医院营养师统一制订,保证热量供给基本相同。所有病人分别于放疗前、中、后抽取静脉血,检测血清清蛋白、前清蛋白、淋巴细胞计数、C反应蛋白、补体C3、IgG和CD3+、CD4+、CD8+和CD4+/CD8+。结果:联合治疗组病人放疗中和放疗结束时血清前清蛋白较单独放疗组升高,且有显著性差异(P<0.05),C反应蛋白和补体C3放疗中较放疗前降低。联合治疗组CD3+、CD4+放疗中较放疗前上升,CD8+下降,与单独放疗组比,放疗中、放疗后CD4+/CD8+升高明显,并且有显著性差异(P<0.01)。结论:Gln和Arg配合放疗可以提高肺癌病人CD4+/CD8+水平,增强细胞免疫功能;同时阻止机体蛋白质降解速度,提高放疗中的营养状况。

Objective： The study was designed to observe the effect of glutamine and arginine in the patients of lung cancer radiotherapy.Methods： 36 cases diagnosed non-small cell lung cancer clinically were randomly divided into the radiotherapy group（n=18） and the combined treatment group（n=18）.Radiotherapy group received radiotherapy alone.Combined treatment group received intravenous arginine and glutamine,Arg 25 g/d [0.5 g/（kg·d）],glutamine 20 g/d [0.4 g/（kg·d）] in 1-10 days while accepting radiotherapy.All patients were detected about ALB,PA,LC,CRP,complement C3,IgG and T cells Subsets CD3^＋,CD4^＋,CD8^＋ and CD4^＋/CD8^＋.Results： PA of the combined treatment group increased significantly P〈0.05 than in radiotherapy group.CD3^＋ and CD4^＋ cells in the combined treatment group increased and CD8^＋ cells decreased.Conclusion： Glutamine and arginine can increase CD4^＋/CD8^＋ in lung cancer radiotherapy,and enhance cellular immune function and nutritional status.