肠内免疫营养对老年食管癌病人术后免疫水平的影响

Effect of enteral immunonutrition on postoperative immune function in elderly patients with esophageal carcinoma

目的:研究肠内免疫营养(EIN)制剂对老年食管癌病人术后免疫水平的影响。方法:选取老年食管癌病人92例,随机分为两组,试验组给予EIN,对照组给予普通肠内营养(EN)。两组病人术后均给予同等的热量和氮量,于术前1 d、术后第1和第8天分别检测相关的营养和免疫指标,包括血清总蛋白(TP)、前清蛋白(PA)、清蛋白(ALB)、转铁蛋白(TF)、Ig G、Ig A、Ig M、CD3、CD4、CD4/CD8、NK细胞,并对各项指标进行比较和分析。结果:两组病人术前各项免疫和营养指标均无显著性差异(P>0.05)。术后第1天,各组血清蛋白指标和免疫指标均明显低于术前1 d。术后第8天,两组病人血清蛋白水平较术后第1天明显上升,但组间差异无统计学意义(P>0.05),试验组免疫指标Ig G、CD3、CD4、CD4/CD8、NK细胞明显高于对照组,差异有显著性统计学意义(P<0.05)。试验组病人的住院时间缩短,感染并发症的发生率降低。结论:老年食管癌术后应用EIN制剂可提高病人的免疫功能,降低术后感染并发症的发生率,缩短住院时间。

Objective： To study the effect of enteral immunonutrition on postoperative immune function in elderly patients with esophageal carcinoma. Methods： 92 elderly patients with esophageal carcinoma who were collected from January 2010 to August 2012 were randomly divided into enteral immunonutrition group and common enteral nutrition group. Both of them were given isocalorie and isoni- trogenous nutrition, and the nutrition and immune indices were measured on preoperative day 1 and post- operative day i and 8. Results： The preoperative nutrition and immune indices were comparable between the two groups（P 〉0.05 ）. Compared with preoperative day 1 all the serum protein parameters significantly decreased in the two groups on postoperative day 1, while immune indices such as IgG, IgA, IgM, CD3, CD4, NK cell were protein parameters significantly CD4,CD4/CD8, NK cell were significantly decreased. Compared with postoperative day 1 all the serum increased on postoperative day 8. The immune indices such as IgG, CD3, significantly increased in enteral immunonutrition group compared with common enteral nutrition group（P 〈 0.05 ） on postoperative day 8. The average hospitalization days was shorter and the incidence of infectious complications was lower in enteral immunonutrition group.Conclusion：Enteral immunonutrition can significantly improve the immune function of elderly patients with esophageal carcinoma, reduce the incidence of infectious complications and shorten the average hospitalization days.