胃癌手术后早期肠内营养对T淋巴细胞亚群的影响

THE EFFECTS OF EARLY ENTERAL NUTRITION ON T-LYMPHOCYTE SUBSETS IN PATIENTS WITH GASTRIC CARCINOMA AFTER OPERATIONS

目的 探讨胃癌病人手术后早期肠内营养对T淋巴细胞免疫功能的影响.方法30例胃癌根治术病人随机分成3组:对照组、肠外营养组(TPN组)、肠内营养组(TEN组),分别给予普通静脉输液、全肠外营养及全肠内营养8d.术前、术后第1、3、6、9天以碱性磷酸酶——抗碱性磷酸酶(APAAP)法测定T淋巴细胞亚群(CD_3、CD_4、CD_8)变化.结果 对照组和TPN组术后CD_3、CD_4阳性细胞数及CD_4/CD_8比值明显降低,CD_8阳性细胞数明显升高.TEN组术后第1天CD_3CD_4阳性细胞数及CD_4/CD_8比值明显降低,但自术后第3天起即开始上升,并逐渐恢复至术前水平.术后第3、6、9天CD_3.CD_4阳性细胞数及CD_4/CD_8比值明显高于对照组和TP N组(P<0.05),而CD_8阳性细胞数明显低于对照组和TPN(P<0.05),术后第9天时CD_4/CD_8比值明显高于术前水平.结论 早期肠内营养可纠正胃癌手术后病人的T淋巴细胞免疫抑制状态,促进T淋巴细胞免疫功能的恢复.

Objective: To study the effect of early enteral nutrition on T-lymphocyte subsets in patients with gastric carcinoma after operations. Methods: 30 patients with gastric carcinoma were divided into three groups after radical resections: control group, TPN group,and TEN group. The changes of T-lymphocyte subsets were determined by A-PAAP mehtod at postoperative 0,1,3,6,9 days. Results: The number of CD3 and CD4 positive cell and CD4/CD8 rate decreased significantly,and CD8 cell number increased markedly in control group and TPN group after operations. In TEN group, the number of CD3 and CD4 positive cell and CD4/CD8 rate decreased at the lst day after operation,but then recovered gradually from the 3th day after operation. The number of CD3 and CD4 positivecell and CD4/CD8 rate in TEN group were higher than those of in central group and TPN group at the 3th,6th,9th days after operations(P<0.05). Conclusion: Early enteral nutrition can enhance T-lymphocyte immune function and improve lymphocytic immunosup-pression after operations in patients with gastric carcinoma.