早期肠内免疫营养干预对胰腺癌术后胃肠激素、应激激素及免疫应答的影响

Effect of early enteral immunonutrition intervention on gastrointestinal hormones,stress hormones and immune response after pancreatic cancer surgery

目的:研究早期肠内免疫营养干预对胰腺癌术后胃肠激素、应激激素及免疫应答的影响。方法:选择在本院接受胰腺癌根治术的68例患者作为研究对象,随机分为TPF-T组和TP组,分别接受术后早期肠内免疫营养干预和常规肠内营养干预。手术前及手术后3、7天时,检测血清中胃肠激素MTL、GAS、CGRP、Ghrelin、应激激素ACTH、Cor、R、AT-II、ALD的含量以及外周血中免疫细胞CD4+T细胞、CD8+T细胞、NKT细胞、Treg、Breg、MDSC的含量。结果:手术后3、7天时,两组血清中MTL、GAS、CGRP、Ghrelin的含量以及外周血中CD4+T细胞、CD8+T细胞、NKT细胞的含量较手术前显著降低,血清中ACTH、Cor、R、AT-II、ALD的含量以及外周血中Treg、Breg、MDSC的含量较手术前显著升高;且TPF-T组患者术后血清中MTL、GAS、CGRP、Ghrelin的含量以及外周血中CD4+T细胞、CD8+T细胞、NKT细胞的含量显著高于TP组,术后血清中ACTH、Cor、R、AT-II、ALD的含量以及外周血中Treg、Breg、MDSC的含量显著低于TP组。结论:胰腺癌术后早期肠内免疫营养干预能够调节胃肠激素分泌、抑制应激反应并改善免疫应答。

Objective：To study the effect of early enteral immunonutrition intervention on gastrointestinal hormones,stress hormones and immune response after pancreatic cancer surgery.Methods：A total of 68 patients who received radical operation for pancreatic cancer in Chengdu Third People＇s Hospital between May 2015 and February 2017 were selected as the research subjects and randomly divided into TPF-T group and TP group who received early postoperative enteral immunonutrition intervention and conventional enteral nutrition intervention,respectively.The levels of gastrointestinal hormones MTL,GAS,CGRP,Ghrelin and stress hormones ACTH,Cor,R,AT-II,ALD in serum as well as the levels of immune cells CD4＋T,CD8＋T,NKT,Treg,Breg,MDSC in peripheral blood were detected before surgery as well as 3and 7dafter surgery.Results：Three and seven days after surgery,MTL,GAS,CGRP and Ghrelin levels in serum as well as CD4＋T cell,CD8＋T cell and NKT cell levels in peripheral blood of both groups of patients were significantly lower than those before surgery while ACTH,Cor,R,AT-II and ALD levels in serum as well as Treg,Breg and MDSC levels in peripheral blood were significantly higher than those before surgery,and MTL,GAS,CGRP and Ghrelin levels in serum as well as CD4＋T cell,CD8＋T cell and NKT cell levels in peripheral blood of TPF-T group were significantly higher than those of TP group while ACTH,Cor,R,AT-II and ALD levels in serum as well as Treg,Breg and MDSC levels in peripheral blood were significantly lower than those of TP group.Conclusions：Early postoperative enteral immunonutrition intervention can regulate the gastrointestinal hormone secretion,inhibit stress response and improve immune response.