胃肠癌术后肠外营养支持加精氨酸强化对机体免疫功能的影响

Immune function affer postoperative parenteral nutrition enriched with arginine in patients with gastrointestional carcinoma

目的 :观察胃肠癌术后肠外营养支持加精氨酸强化对机体免疫功能的影响。 方法 :选择胃肠癌行根治术后病人 40例 ,随机分为试验组和对照组。试验组采用精氨酸强化肠外营养支持 ,对照组应用常规的肠外营养支持。分别在术前、术后第 1天及第 8天检测IgG、IgA、IgM、T细胞亚群、NK细胞活性和IL 2的改变。 结果 :胃肠癌病人术前均有不同程度的免疫功能低下 ,术后第 1天IgG、IgA、IgM、CD4+、CD4+/CD8+、NK细胞活性和IL 2均较术前显著下降 ,术后第 8天试验组上述指标迅速恢复 ,并超过术前水平 ,与对照组相比差异显著 (P <0 .0 1 )。 结论

Objectives:In order to study the immune function after postoperative parenteral nutrition enriched with arginine in patients with gastrointestinal carcinoma. Methods:Forty patients who underwent radical operation of gastrointestinal carcinoma were randomly divided into experimental group( n= 20),in which patients received TPN enriched with arginine,and control group (TPN, n =20).At day 1 before operation,day 1 and day 8 after operation,IgG,IgA,IgM,T cell subgroups.NK cell activity and IL 2 were dectected. Results:The immune function of patients with gastrointestinal carcinoma was depressed at different levels.At day 1 after operation,IgG,IgM,IgA,CD4 +,CD4 +/CD8 +,Nk cell activity and IL 2 decreased more significantly than those before operation.The immunefunction recovered rapidly and exceeded the level before preoperation in experimental group.The difference was significant( P <0.01)between groups. Conclusions:TPN enriched with arginine could significantly improve the immune function for postoperative patients with gastrointestinal carcinoma.