胃癌手术后早期肠内营养对T淋巴细胞亚群的影响

THE EFFECTS OF EARLY ENTERAL NUTRITION ON T-LYMPHOCYTE SUBSETS IN PATIENTS WITH GASTRIC CARCINOMA AFTER OPERATION

目的 :探讨早期肠内营养对胃癌病人手术后 T淋巴细胞免疫功能的影响。方法 :30例胃癌根治术病人随机分成 3组 ,即对照组、肠外营养组 (PN组 )、肠内营养组 (EN组 ) ,分别给予普通静脉输液、肠外营养及肠内营养 8d。术前及术后第 1、3、6、9天以碱性磷酸酶 -抗碱性磷酸酶 (APAAP)法测定 T淋巴细胞亚群(CD3、CD4 、CD8)的变化。结果 :对照组和 PN组术后 CD3、CD4 阳性细胞数及 CD4 /CD8比值明显降低 ,CD8阳性细胞数明显升高。EN组术后第 1天 CD3、CD4 阳性细胞数及 CD4 /CD8比值明显降低 ,但自术后第 3天起即开始上升 ,并逐渐恢复至术前水平 ;术后第 3、6、9天 CD3、CD4 阳性细胞数及 CD4 /CD8比值明显高于对照组和 PN组 (P<0 .0 5) ,而 CD8阳性细胞数明显低于对照组和 PN组 (P<0 .0 5) ,术后第 9天时 CD4 /CD8比值明显高于术前水平。结论 :早期肠内营养可纠正胃癌手术后病人的 T淋巴细胞免疫抑制状态 ,促进 T淋巴细胞免疫功能的恢复。

Objective:To explore the effect of early enteral nutrition on T-lymphocyte subsets in patients with gastric carcinoma after operation.[WT5HZ]Methods:Thirty patients with gastric carcinoma were divided into three groups after radical resection,contral group,PN group,and EN group.The changes of T-lymphocyte subsets were determined by APAAP method on the 0,1,3,6,9 day postoperatively.[WT5HZ]Results:The CD 3 and CD 4 positive cell counts and CD 4/CD 8 rate decreased and CD 8 cell count increased in contral group and PN group significantly after operation.In EN group,the CD 3 and CD 4 positive cell counts and CD 4/CD 8 rate decreased on the lst day after operation,but then recovered gradually from the 3th day after operation.The CD 3 and CD 4 positive cell count and CD 4/CD 8 rate in TEN group were higher than those in contral group and PN group on the 3th,6th,9th days after operation( P <0 05) [WT5HZ]Conclusions:Early enteral nutrition can enhance T-lymphocyte immune function and improve lymphocytic immunosuppression after operation in patients with gastric carcinoma. [WT5HZ]