术后早期肠内免疫营养对胃恶性肿瘤病人的作用  

Influence of early postoperative enteral immunonutrition on patients with malignant gastric tumor

作　　者：鞠兴唐[1] 蒋小华[1] 李俊生[1] 刘胜利[1] 

机构地区：[1]东南大学附属中大医院普外科,南京210009

出　　处：《江苏医药》2005年第9期664-665,共2页Jiangsu Medical Journal

摘　　要：目的研究术后早期肠内免疫营养对胃恶性肿瘤病人免疫、炎症反应及预后的影响。方法42例胃恶性肿瘤病人随机分为免疫营养组(研究组)和常规营养组(对照组),于术后第2天开始,分别给予等氮、等热卡的肠内营养支持,并于术前1d、术后1d和术后9d分别检测IgG、Ig M、IgA、CD4、CD8、CD4/CD8、IL-1α、IL-2、IL-6、IL-10、TNF-α,并观察感染并发症的发生情况。结果肠内营养结束后,研究组IgA、CD4、CD4/CD8水平均显著高于对照组,IL-6水平显著低于对照组,两组感染并发症的发生率无明显差异。结论胃恶性肿瘤病人手术后早期使用肠内免疫营养可减轻机体炎症反应,改善免疫功能,改善病人的预后。Objective To evaluate the influence of early postoperative enteral immunonutrition on immune, inflammatory responses and clinical outcome of paitents with malignant gastric tumor. Methods Fourty two patients with gastric cancer were randomized to receive either an immune enhancing enteral diet or an isocaloric, isonitrogenous control diet for 7 days. Enteral nutrition started on the 2^nd postoprative day. On the day before operation, the first postoperative day and the 9^th postoperative day, host immunity was evaluated by the measurements of IgG, IgM, IgA, CD4, CD8, CD4/CD8, and inflammatory response was investigated by dectecting IL1-aα IL-2, IL-6, IL-10, TNF-α. Infectious complications were recorded as well. Results After nutrition, IgA, CD4, and CD4/CD8 levels were significantly higher in study group than those in control group. IL-6 concentration was significantly lower in study group than that in control group. No statistical difference was found in infectious complications between two groups. Conclusion Early postoperative administration of immunonutrition in paitents with malignant gastric tumor can enhace host immunity, modulate host inflammatory responses and improve the clinical outcome.

关 键 词：肠内营养 免疫 炎症反应 胃恶性肿瘤 早期肠内免疫营养 恶性肿瘤病人 手术后 CD4/CD8 肠内营养支持 机体炎症反应 

分 类 号：R735.9[医药卫生—肿瘤] R473.73[医药卫生—临床医学]