添加丙谷双肽的肠外营养在胃肠道肿瘤患者化疗中的应用  

The Prospective Study on Application of Parenteral Nutrition with Alanyl-glutamine Dipeptide in Chemotherapy of Gastrointestinal Neoplasms Patients

作　　者：彭亦良[1] 龚茜芬[1] 王自强[1] 

机构地区：[1]第三军医大学西南医院,重庆400038

出　　处：《癌症》2006年第8期1044-1047,共4页Chinese Journal of Cancer

摘　　要：背景与目的:恶性肿瘤尤其是消化系统肿瘤患者常出现进行性营养不良,但添加外源性谷氨酰胺(Gln)是否能够改善肿瘤患者营养状况尚有争议。本研究目的在于探讨添加丙氨酰谷氨酰胺(Ala-Gln)双肽的肠外营养(parenteralnutrition,PN)在胃肠道肿瘤患者化疗中的应用价值。方法:在本次双盲、随机、前瞻性试验中,将72例胃肠道肿瘤患者随机分为常规PN组(对照组)36例和Ala-GlnPN组(试验组)36例,检测化疗前后血清白蛋白、血清前蛋白、氮平衡变化,以及外周血中IgG、IgM、IgA、C3、C4值的变化。结果:(1)化疗期间试验组患者胃肠道反应低于对照组(P<0.05)。(2)两组患者血清白蛋白、前白蛋白在化疗后第4天均明显下降,化疗后第8天时继续下降,但对照组下降更快,两组比较差异有显著性(P<0.05)。(3)两组患者化疗后第4天IgG、IgA、IgM值值均低于化疗前,化疗后第8天IgG、IgA、IgM值进一步下降,但试验组下降较慢,与对照组比较差异有显著性(P<0.05)。试验组化疗后第8天C3、C4值也高于对照组(P<0.05)。(4)试验组化疗后第8天氮平衡明显优于对照组(P<0.01)。结论:在胃肠道肿瘤患者化疗中应用Ala-Gln双肽PN利大于弊,可明显减轻化疗的毒副作用,有助于改善患者化疗期间的营养状况,增强患者的免疫功能。BACKGROUND ＆ OBJECTIVE： There is an argument on whether or not glutamine-supplemented parenteral nutrition is beneficial to chemotherapy in gastrointestinal neoplasm patients. The aim of this study was to prospectively evaluate the effect of parenteral nutrition with alanyl-glutamine dipeptide on gastrointestinal neoplasm patients receiving chemotherapy. METHODS： This study was a prospective, randomized double-blind clinical trial. Seventy-two patients were randomly divided into study group and control group （each group had 36 patients）. The side effects during chemotherapy were observed. Serum albumin, serum pre-albumin, IgG, IgA, IgM, C3, C4 level were measured before chemotherapy and on day 4 and day 8 after chemotherapy. Nitrogen balance was also calculated simultaneously. RESULTS： （1）Less side effects during chemotherapy in study group were revealed compared to those in control group （P〈0.05）. （2）Serum albumin and pre-albumin levels were both decreased in the two groups on day 4 after chemotherapy, and were markedly decreased in control group on day 8 after chemotherapy （P〈0.05）. （3）IgG, IgM, IgA levels were all decreased compared with the test results before chemotherapy on day 4 after chemotherapy in two groups, and were significantly decreased in control group on day 8 after chemotherapy （P〈0.05）. C3 and C4 levels were higher in study group compared with control group on day 8 after chemotherapy （P〈0.05）. （4） Nitrogen balance in study group was better than that in control group （P〈 0.05） on day 8 after chemotherapy. CONCLUSIONS： Alanyl-glutamine dipeptide is beneficial to chemotherapy in gastrointestinal neoplasm patients. It could reduce the side effects of chemotherapy, which helps to improve the nutritional status, the immune function and the survival quality of patients during chemotherapy.

关 键 词：胃肠道肿瘤/化学疗法 丙氨酰谷氨酰胺双肽 肠外营养 

分 类 号：R735[医药卫生—肿瘤]