个体化精准营养干预改善老年胃癌术后患者营养状况及免疫功能的作用

Effect of Individualized Precision Nutrition Improving Nutritional Status and Immune Function in Elderly Patients with Gastric Cancer after Surgery

目的:研究个体化精准营养干预对老年胃癌手术患者营养状况、免疫功能及血清热休克蛋白70(HSP70)表达的影响。方法:选择2019年2月—2021年2月在衡阳市中心医院华新院区接受手术治疗的84例老年胃癌患者,以随机数字表法将其分成干预组(n=42)及对照组(n=42)。对照组开展常规营养支持,干预组则开展个体化精准营养干预。对比两组营养状况、免疫功能及血清HSP70水平变化情况,以及术后感染发生情况。结果:术后10 d干预组总蛋白及血清白蛋白水平分别为(73.41±9.29)、(39.05±6.23)g/L,均高于对照组的(65.89±8.45)、(34.71±5.77)g/L(P<0.05)。术后10 d干预组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)分别为(65.48±4.85)%、(45.27±4.66)%、(1.72±0.43),均高于对照组的(62.03±4.72)%、(41.34±4.12)%、(1.44±0.32),CD8+水平为(26.28±1.12)%,低于对照组的(28.78±1.25)%(P<0.05)。术后10 d干预组及对照组血清HSP70水平分别为(404.58±102.74)、(467.23±106.19)μg/L,均低于术前的(704.58±122.74)、(703.49±114.85)μg/L,且干预组均低于对照组(P<0.05)。干预组术后感染总发生率低于对照组(P<0.05)。结论:个体化精准营养干预可显著改善老年胃癌手术患者营养状态及免疫功能,同时下调血清HSP70水平,降低术后感染风险。

Objective:To study the effect of individualized precision nutrition intervention on nutritional status,immune function and expression of serum heat shock protein 70(HSP70)in elderly patients underwent gastric cancer surgery.Method:A total of 84 elderly patients with gastric cancer who received surgical treatment in Huaxin Hospital District,Hengyang Central Hospital from February 2019 to February 2021 were selected and divided into intervention group(n=42)and control group(n=42)according to random number table method.The control group received routine nutrition support,and the intervention group received individualized precision nutrition intervention.The nutritional status,immune function,serum HSP70 level change and the incidence of postoperative infection were compared between the two groups.Result:After 10 days of surgery,the levels of total protein and serum albumin in the intervention group respectively was(73.41±9.29)and(39.05±6.23)g/L,which were higher than(65.89±8.45)and(34.71±5.77)g/L in the control group(P<0.05).After 10 days of surgery,CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in the intervention group respectively was(65.48±4.85)%,(45.27±4.66)%and(1.74±0.43),which were higher than(62.03±4.72)%,(41.34±4.12)%and(1.44±0.32)in the control group,and CD8+level in the intervention group was(26.28±1.12)%,which was lower than(28.78±1.25)%in the control group(P<0.05).After 10 days of surgery,the serum HSP70 levels in the intervention group and the control group respectively was(404.58±102.74)and(467.23±106.19)μg/L,which were lower than(704.58±122.74)and(703.49±114.85)μg/L before surgery,and those in the intervention group were lower than those in the control group(P<0.05).The total incidence of postoperative infection in the intervention group was lower than that in the control group(P<0.05).Conclusion:Individualized precision nutrition intervention can significantly improve the nutritional status and immune function of elderly patients undergoing gastric cancer surgery,and down-regulated serum HSP70 level and reduce the risk of postoperative infection.