补充丙氨酰谷氨酰胺对老年食管癌患者同步放化疗治疗顺应性的影响

Study of alanyl-glutamine supplements on treatment compliance in elderly patients with esophageal cancer on concurrent chemo-radiotherapy

目的观察丙氨酰谷氨酰胺对老年食管癌患者同步放化疗的作用。方法收集2015年11月至2018年11月在泰安市肿瘤防治院进行同步放化疗的老年食管癌患者60例,使用随机数字表法分为试验组和对照组。两组均进行常规营养支持及膳食指导,试验组放疗日每日补充丙氨酰谷氨酰胺20 g/天,对照组仅行常规营养支持及膳食指导。比较放疗前后两组患者部分血液学营养指标、体重变化情况、不良反应发生率、治疗完成率、外周T淋巴细胞比率变化情况。结果经放化疗后,对照组白蛋白和血红蛋白均显著下降,两组比较差异有统计学意义(P<0.05);与治疗前比较,试验组治疗后血前白蛋白水平比对照组高(P<0.05);经过放化疗后,对照组血转铁蛋白下降(P<0.05),试验组血转铁蛋白比对照组高(P<0.05);放射性食管炎及骨髓抑制发生率试验组明显低于对照组(P<0.05);两组体重及放射性肺炎发生率治疗前后无明显变化;两组比较免疫指标变化差异有统计学意义(P<0.05);试验组患者按治疗计划完成率高于对照组(P<0.05)。结论对于食管癌同步放化疗患者,补充丙氨酰谷氨酰胺有利于改善营养状态、降低并发症发生率、减少免疫力下降可能性,进而提高患者的治疗顺应性。

Objective To investigate the effect of alanyl-glutamine supplements in elderly patients with esophageal cancer on concurrent chemo-radiotherapy.Methods From November 2015 to November 2018,60 Elderly patients who were treated in our hospital with esophageal cancer on concurrent chemo-radiotherapy were recruited and randomly divided into the experimental group and the control group by random digits table.Both groups received routine nutritional support and dietary guidance,while only the experimental group received alanyl-glutamine supplements(20 g/d)on radiotherapy day.We compared blood indicators,changes in body weight,incidence of complications,completion rates of therapy and the T lymphocyte percentage of peri-pheral blood between the two groups.Results After chemoradiotherapy,albumin and hemoglobin of the control group decreased significantly,and the difference between the two groups was statistically significant,P<0.05.Compared with before treatment,the serum prealbumin level of the experimental group was higher than that of the control group,P<0.05.After chemoradiotherapy,serum transferrin of the control group decreased,P<0.05,and serum transferrin of the experimental group was higher than that of the control group,P<0.05.The incidence of radiation esophagitis and bone marrow suppression of the experimental group was significantly lower than that of the control group,P<0.05.There were no significant changes of body weight and incidence of radiation pneumonia before and after treatment in the two groups.The difference of immune indexes between the two groups was statistically significant,P<0.05.The completion rate of the treatment plan of the experimental group was higher than in the control group,P<0.05.Conclusion For patients undergoing concurrent chemoradiotherapy for esophageal cancer,supplementing alanyl glutamine is beneficial to improve nutritional status,reduce the incidence of complications,reduce the possibility of immune decline,and thus improve the therapeutic compliance of patients.