肠内营养支持对鼻咽癌放疗患者免疫功能、营养状态的影响

Effect of enteral nutrition support on immune function and nutritional status of patients with nasopharyngeal carcinoma after radiotherapy

目的探讨肠内营养支持对鼻咽癌放疗患者免疫功能、营养状态的影响。方法依据营养支持方式的不同将106例鼻咽癌患者分为常规组和观察组,每组53例,常规组患者放疗后给予常规营养支持,观察组患者放疗后给予肠内营养支持。比较两组患者的营养状态指标[三头肌皮褶厚度(TSF)、上臂围、腰围、患者主观整体营养评估量表(PG-SGA)评分]及体重指数(BMI)、营养生化指标[总蛋白(TP)、转铁蛋白(TRF)、前白蛋白(PAB)、白蛋白(ALB)]、免疫功能指标[辅助性T细胞(Th)17、Th22、调节性T细胞(Treg)、T淋巴细胞亚群(CD3^(+)、CD4^(+)/CD8^(+))]、炎性因子[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]及不良反应发生情况。结果干预后,观察组患者TSF、上臂围、腰围均大于常规组,BMI高于常规组,PG-SGA评分低于常规组,差异均有统计学意义(P﹤0.05)。干预后,观察组患者TRF、ALB、PAB、TP、Th17、Th22、CD3^(+)水平及CD4^(+)/CD8^(+)均高于常规组,CRP、PCT、IL-6、TNF-α、Treg水平均低于常规组,差异均有统计学意义(P﹤0.05)。观察组患者的不良反应总发生率为7.55%,低于常规组患者的22.64%,差异有统计学意义(P﹤0.05)。结论鼻咽癌放疗后给予肠内营养支持能够更好地改善患者的营养状态,增强患者的免疫功能,减轻炎性反应,且营养支持方案安全可行,不良反应少。

Objective To explore the effect of enteral nutrition support on immune function and nutritional status of patients with nasopharyngeal carcinoma after radiotherapy.Method According to different nutritional support methods,106 patients with nasopharyngeal carcinoma after radiotherapy were divided into conventional group and observation group,with 53 cases in each group.Patients in conventional group received conventional nutritional support after radiotherapy,while patients in observation group received enteral nutritional support after radiotherapy.The nutritional status indicators[triceps skinfold thickness(TSF),upper arm circumference,waist circumference,and patient-generated subjective global assessment(PG-SGA)score]and body mass index(BMI),nutritional biochemical indicators[total protein(TP),transferrin(TRF),prealbumin(PAB),albumin(ALB)],immune function indicators[helper T cell(Th)17,Th22,regulatory T cell(Treg),T lymphocyte subsets(CD3^(+),CD4^(+)/CD8^(+))],inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]and incidence of adverse reactions were compared between the two groups.Result After intervention,the TSF,upper arm circumference,and waist circumference in observation group were bigger than those in conventional group,the BMI was higher than that in conventional group,and the PG-SGA score was higher than that in conventional group,and the differences were statistically significant(P<0.05).After intervention,the levels of TRF,ALB,PAB,TP,Th17,Th22,CD3^(+)and CD4^(+)/CD8^(+)in observation group were higher than those in conventional group,while the levels of CRP,PCT,IL-6,TNF-αand Treg in observation group were lower than those in conventional group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in observation group was 7.55%,which was lower than 22.64%in conventional group,and the difference was statistically significant(P<0.05).Conclusion Enteral nutrition support after radiotherapy for nasopharyngeal carcinoma patients can better improve nutritional status,enhance their immune function,reduce inflammatory reactions,and the nutritional support plan is safe and feasible with fewer adverse reactions.