不同营养途径对食管癌术后细胞免疫功能的影响

The effect of different nutrition support route on the cellular immune function of patients after esophagectomy

目的 探讨不同营养途径对食管癌术后细胞免疫功能的影响.方法 将62例食管癌手术治疗患者应用随机数字表随机分为早期肠内营养（EN）组和肠外营养（PN）组,各31例;分别于术前及术后第1、8天进行细胞免疫指标（T淋巴细胞及其亚群、自然杀伤细胞、B淋巴细胞）检测,两组计量资料的比较采用t检验,两组多个时间点计量资料的比较采用重复测量资料的方差分析.结果 EN组术前CD3、CD4、CD8、CD4/CD8、自然杀伤细胞和B淋巴细胞分别为（60.46±6.41）％、（39.03±5.64）％、（25.06±5.39）％、1.60±0.24、（13.86±4.91）％、（13.14±3.81）％,术后第8天分别为（65.18±7.81）％、（40.45±6.82）％、（22.81±4.47）％、1.78±0.16、（16.97 ±4.85）％、（15.69±3.88）％,与术前比较差异均有统计学意义（P均＜0.05）;PN组术前CD3、CD4、CD8、CD4/CD8、自然杀伤细胞和B淋巴细胞分别为（59.78±5.17）％、（39.10±5.49）％、（24.94±3.97）％、1.57±0.20、（14.02±4.47）％、（12.96±3.39）％,术后第8天分别为（60.27±6.20）％、（39.71±5.63）％、（24.74±3.80）％、1.62±0.15、（15.35±4.31）％、（14.33±3.43）％,与术前比较除CD3、CD8外差异均有统计学意义;EN组与PN组术后第8天比较除CD4外差异均有统计学意义（P均＜0.05）.结论 食管癌术后早期EN较PN可显著改善患者的细胞免疫功能.

Objective To explore the nutrition support route of enteral nutrition （EN） and parenteral nutrition（PN） on the cellular immune function of patients after esophagectomy.Methods Sixty-two patients with esophageal surgery were randomly divided into EN group and the PN group,and each was 31 cases.Cellular immune indexes（including T lymphocyte subsets,natural killer cells,B lymphocytes） were measured at the preoperation,the postoperative 1st day and 8th day.The t test was preformed to compare the measurement data of two groups,and repeated measures analysis of variance was used to compare multiple time points of measurement data of two groups.Results The levels of CD3,CD4,CD8,CD4/CDS,NK cells and B cells in EN group at before operation were （60.46 ± 6.41） ％,（39.03 ± 5.64） ％,（25.06 ± 5.39） ％,（1.60 ± 0.24）,（13.86 ±4.91）％,（13.14 ± 3.81）％ respectively,and those indices at 8th day after operation were （65.18 ±7.81）％,（40.45 ±6.82）％,（22.81 ±4.47）％,（1.78 ±0.16）,（16.97 ±4.85）％,（15.69 ± 3.88）％ respectively,and the differences were statistically significant（P ＜ 0.05）.The levels of CD4,CD4/CD8,NK cells and B cells in PN group at before operation were （59.78 ± 5.17） ％,（39.10 ± 5.49） ％,（24.94 ± 3.97） ％,1.57 ±0.20,（14.02 ± 4.47） ％,（12.96 ± 3.39） ％ respectively,significantly different from that of 8th days （（59.78 ±5.17）％,（39.71 ±5.63）％,（24.74 ±3.80）,（1.62 ±0.15）,（15.35 ±4.31）％,（14.33 ±3.43） ％ respectively）,and there were significant difference compared to before operation in terms of CD4,CD4/CD8,NK cells and B cells.At the 8th day after operation,there was significant difference between in EN group and PN group in terms of CD3,CD8,CD4/CD8,NK cells and B cells（P ＜0.05）.Conclusion Early EN for patients after esophageal carcinoma operation can significantly improve the cellular immune function of patients.