益生菌对结直肠癌化疗患者营养状况、炎性反应及化疗相关并发症的影响

Effect of probiotics on nutritional status,inflammatory reaction and chemotherapy-related complications in patients having undergone chemotherapeutic treatment of colorectal cancer

目的探讨复合益生菌对结直肠癌化疗患者营养状况、炎性反应及相关并发症的影响,寻求适宜结直肠癌化疗患者的营养评估方法。方法选取符合标准的需要化疗的结直肠癌患者98例,随机分为对照组及观察组。2组患者使用相同的化疗方案治疗一周期,常规护理,观察组在化疗的同时给予复合益生菌。观察2组化疗相关并发症的发生情况,及治疗前后2组患者营养状况、炎性反应的变化情况。结果PG-SGA、NRS2002、BMI、ALB、PA结果显示,患者营养不良发生率分别为57.1%、39.8%、19.4%、24.5%、32.7%。与治疗前相比,治疗后2组患者PG-SGA、NRS2002及PA得到显著改善,且观察组PG-SGA及PA改善情况优于对照组,差异均有统计学意义(P<0.05)。治疗期间,观察组恶心、呕吐、腹泻及食欲降低发生情况都低于对照组;化疗后,两组患者hs-CRP均下降,差异均有统计学意义(P<0.05)。与对照组相比,观察组CD4^+细胞比例显著升高,CD8^+细胞比例显著下降,CD4^+/CD8^+比值显著升高,差异均有统计学意义(P<0.05)。结论PG-SGA营养不良检出率较高,适用于结直肠癌患者营养状况评价。复合益生菌可以改善化疗患者营养状况,增强患者免疫力,降低化疗相关并发症的发生。

Objective To evaluate the effect of probiotics on nutritional status,inflammatory reaction and chemotherapy-induced complications in patients with colorectal cancer having been subjected to chemotherapeutic treatment so as to identify more reliable method for assessment of the nutrition status of the patients as such.Methods Firstly,98 patients diagnosed with colorectal cancer who met the inclusion criteria were randomly divided into an experimental group and a control group.Secondly,both groups were subjected to the same chemotherapy for one course of treatment and traditional nursing care.Meanwhile,the experimental group were given probiotics.The incidence of chemotherapy-induced complications in the two groups after chemotherapy and the nutritional status and incidence of inflammatory reaction in the two groups as observed before and after chemotherapy were documented and compared.Results The rate of incidence of malnutrition was 57.1%,39.8%,19.4%,24.5%,32.7%as measured by PG-SGA,NRS2002,BMI,ALB,PA respectively.As compared with before treatment,the results of PG-SGA、NRS2002 and PA of both groups after treatment were found to have been improved significantly,with the results in the experimental group being better than those of the control.The differences were statistically significant(P<0.05).During the course of chemotherapy,the rates of incidence of nausea,vomiting,diarrhea and loss of appetite were smaller than those of the control.The hs-CRP levels of both groups were found to have decreased after treatment.The differences were statistically significant(P<0.05).After treatment,the proportion of CD4^+T cells of the experimental group was found to have gone significantly greater than that of the control while the ratio of CD8^+T cells smaller as compared with those of the control group.The ratio of CD4^+/CD8^+was significantly higher than that of the control group.The differences were statistically significant(P<0.05).Conclusions PG-SGA is better at detecting the incidence of malnutrition and thus can serve as a reliable tool for assessment of the nutritious status of patients with colorectal cancer.Probiotics can help improve the nutritional status as well as the immunity of the patients and reduce chemotherapy-induced complications in patients with colorectal cancer.