海洋低聚肽对肝癌术后患者营养状况及免疫功能的影响

Effects of marine oligopeptides on nutritional status and immune function in patients with liver cancer

目的探讨海洋低聚肽对术后肝癌患者营养状况及免疫功能的影响,为海洋低聚肽的临床应用提供一定的理论依据。方法选择湖北省武汉市黄陂区人民医院2018年6月-10月因原发性肝癌住院并需要行肝段或者肝叶切除术的患者,通过随机、双盲平均分为标准肠内营养组(standard enteral nutrition,SEN组)和海洋低聚肽+SEN组,每组各40例。SEN组患者于手术前3 d开始口服能全力(纽迪希亚,1.0 kcal/mL,荷兰)400 mL,手术后继续口服。海洋低聚肽+SEN组患者在SEN组的基础上,手术前3 d至手术后7 d,每日经口摄入10 g海洋低聚肽粉剂。于术前、术后第14天分别检测血清白蛋白(ALB)、前白蛋白(PAB)、总蛋白(TP)及免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)。用流式细胞仪检测外周血T细胞亚群。结果术后14 d,2组TP、PAB和ALB较术前升高,差异有统计学意义。组间比较,术后14 d,海洋低聚肽+SEN组ALB水平高于SEN组,但2组TP和PAB比较差异无统计学意义;CD4^+T细胞、CD8^+T细胞比值明显高于SEN组(P<0.05)。术后2组的IgG、IgA和IgM水平均升高,差异有统计学意义(P<0.05)。SEN组患者肠道通气时间明显短于海洋低聚肽+SEN组(P<0.05),而术后住院时间长于后者(P<0.05)。结论低聚肽在改善肝癌患者的免疫功能方面,尤其是改善细胞免疫方面,具有较大优势,可以改善患者术后免疫抑制状态,降低体内炎症反应,建议推广使用。

ObjectiveTo investigate the effects of marine oligopeptides on nutritional status and immune function in patients with liver cancer.MethodsA total of 80 patients with primary liver cancer who were hospitalized for hepatocellular carcinoma or hepatectomy were selected from the Third Affiliated Hospital of Jianghan University,Huangpu District People′s Hospital,From June2018 to October 2018.The patients were divided into two groups:40 cases of standard enteral nutrition(SEN group),40 cases of marine oligopeptide+SEN group.Patients in the SEN group received Nutrison Fibreoral administration(New Zealand,1.0 Kcal/mL,Netherlands)400 mL at 3 days prior to surgery.The SEN group did not supplement the marine oligopeptide powder throughout the process.Marine oligopeptide+SEN group:On the basis of the SEN group,10 g of marine oligopeptide powder was orally administered daily from 3 days before surgery to 7 days after surgery.Before and 14 dafter surgery,the general indicators,nutritional indicators,cellular immune indexes,and humoral immune indicators were measured,and the recovery time and hospitalization time of postoperative gastrointestinal function were observed.Albumin(ALB),prealbumin(PAB),total albumin(total protein),immunoglobulin G(IgG),immunoglobulin A(IgA)and immunoglobulin Protein M(IgM)were detected.Peripheral blood T lymphocyte subsets were detected by flow cytometry.ResultsOn 14 days after operation,total albumin,prealbumin and albumin increased compared with preoperative in two groups,and the difference was statistically significant.Compared with the SEN group,the levels of albumin in the oligopeptide+SEN group were higher than those in the SEN group at 14 days after operation,but there was no significant difference in total albumin and prealbumin between the two groups.The above indexes both increased in the 2 groups after 14 days.The levels of CD4^+T cells,CD8^+T cells in the marine oligopeptide+SEN group were significantly higher than those in the SEN group,with significant differences(P<0.05).Among the related indexes of humoral immunity,the levels of IgG,IgA and IgM in the SEN group and the marine oligopeptide+SEN group were increased,there was significant difference in the group(P<0.05).The intestinal ventilation time of the marine oligopeptide+SEN group and the SEN group were(54.3±10.31)and(72.3±14.5)h,respectively(P<0.05).The postoperative hospital stay was(12.31±4.2),(11.8±7.2)d(P<0.05).ConclusionOligopeptides have great advantages in improving the immune function of patients with liver cancer,especially in improving cellular immunity.