肠道微生态制剂联合谷氨酰胺对大肠癌患者术后免疫功能的影响

Effect of intestinal microecological preparation combined with glutamine on postoperative immune function of patients with colorectal cancer

目的探讨肠道微生态制剂联合谷氨酰胺对大肠癌患者术后免疫功能的影响。方法选择2018年7月至2019年5月广西壮族自治区人民医院收治的大肠癌患者60例,采用随机数字表法将其分为观察组和对照组,每组30例。对照组术前行传统常规肠道准备(口服复方聚乙二醇或机械清洁灌肠),术后予常规对症支持治疗。观察组术前第3天开始每天口服肠道微生态制剂(双歧杆菌四联菌片及乳果糖)和谷氨酰胺,术后第1天至术后第7天除了常规对症支持治疗外,同时予口服肠道微生态制剂(双歧杆菌四联菌片)和谷氨酰胺。观察比较两组术前及术后第3天、第7天的免疫球蛋白A(IgA)、CD3 T细胞、CD4 T细胞、CD8 T细胞、CD4 T细胞/CD8 T细胞的变化情况。结果两组术后的IgA、CD3 T细胞、CD4 T细胞水平均呈先下降后升高的趋势,且观察组的下降幅度更小而上升幅度更大,差异有统计学意义(P<0.05)。两组术后CD8 T细胞、CD4 T细胞/CD8 T细胞水平也呈先下降后升高的趋势,但两组变化趋势无显著差异(P>0.05)。结论肠道微生态制剂与谷氨酰胺联合应用能有效促进大肠癌患者术后免疫功能的恢复。

Objective To investigate the effect of intestinal microecological preparation combined with glutamine on postoperative immune function of patients with colorectal cancer.Methods Sixty patients with colorectal cancer admitted to the People′s Hospital of Guangxi Zhuang Autonomous Region from July 2018 to May 2019 were selected,and were divided into observation group and control group by random number table method,with 30 cases in each group.The control group received conventional routine bowel preparation(oral compound polyethylene glycol or mechanical cleaning enema)before operation,and received routine symptomatic and supportive treatment after operation.The observation group was given oral intestinal microecological preparations(Live Combined Bifidobacterium,Lactobacillus,Enterococcus and Bacillus cereus Tablets and lactulose)and glutamine every day from the third day before operation.From the first day to the seventh day after operation,in addition to the routine symptomatic and supportive treatment,oral intestinal microecological preparations(Live Combined Bifidobacterium,Lactobacillus,Enterococcus and Bacillus cereus Tablets)and glutamine were also given to the observation group.The changes of immunoglobulin A(IgA)and T-lymphocyte subpopulation levels(CD3 T cells,CD4 T cells,CD8 T cells,and CD4 T cells/CD8 T cells)were observed and compared between the two groups before operation and on the third day and the seventh day after operation.Results The levels of IgA,CD3 T cells and CD4 T cells in the two groups showed a trend of decline and then rise after operation,and the observation group had a smaller decline and a greater increase,and the differences were statistically significant(P<0.05).The levels of CD8 T cells,and CD4 T cells/CD8 T cells in the two groups also showed a tendency to decrease first and then increase after operation,but there were no significant differences in the trends between the two groups(P>0.05).Conclusion Combined application of intestinal microecological preparation and glutamine can effectively promote the recovery of postoperative immune function in patients with colorectal cancer.