肠内免疫营养对食管癌化疗病人营养状况、血液毒性和免疫功能影响的临床研究

Clinical study on the effects of enteral immunonutrition preparation on nutritional status, blood toxicity,immune function in esophageal cancer patients receiving chemotherapy

目的:评价肠内免疫营养对食管癌化疗病人营养状态、血液毒性和免疫功能的情况。方法:将30例食管癌化疗病人随机分对照组和肠内免疫营养组,每组15例。观察各组病人治疗后的营养状态、血液毒性和T细胞亚群的变化。结果:①营养状态:化疗后第7天,两组病人血清前清蛋白和转铁蛋白较化疗前显著降低(P<0.05),第14和21天,肠内免疫营养组前清蛋白和转铁蛋白显著优于对照组(P<0.05);②血液学毒性:对照组有8例(53%)出现Ⅲ度血液学毒性,而肠内免疫营养组仅出现1例(6.7%);③T细胞亚群:对照组病人化疗前后辅助性T细胞(CD4+)和CD4+/CD8+比值明显下降(P<0.05),肠内免疫营养组反而上升(P<0.05)。结论:肠内免疫营养可减轻化疗引发的毒副反应,改善病人的营养状态,增强机体的免疫功能。

Objective： Enteral immunonutrition was used on esophageal cancer patients undergo- ing chemotherapy to evaluate the influence on nutritional status, blood toxicity, immune function. Methods： 30 cases of esophageal cancer chemotherapy patients were randomly divided into blank control group, enteral immunonutrition group. The changes of nutritional status, blood ceils and T lymphocyte subsets after treatment in each group were evaluated. Results： Compared with the levels before chemo- therapy, serum prealbumin and transferrin were significantly decreased in all 2 groups on the 7th day after chemotherapy （ P 〈 0.05 ）, while enteral immunonutrition group was significantly increased （ P 〈 0.05 ） than the other group on 14th and 21th days. The existence of Grade m hematologic toxicity was 53% （8 in 15 cases） in blank control group. After chemotherapy,T helper cells（ CD4＋ ） and ratio of CD4＋ , CD8＋ （ CD4 ＋/CD8＋） were significantly decreased in blank control group （ P 〈 0.05 ）, and CD4＋ and CD4＋/CD8＋ were significantly increased in enteral immunonutrition group （ P 〈 0.05 ）. Conclusion ： Chemotherapy may cause blood toxicity and decline nutritional status and immune function in patients with esophageal cancer. Enteral immunonutrition can reduce the side effects of chemotherapy, improve the nutritional status and enhance immunity of patients.