精氨酸对结肠、直肠癌病人免疫功能及肿瘤细胞增殖活性的影响  

Effect of arginine on the immune function and tumor cell proliferating activity in patients with colorectal cancer

作　　者：胡新华[1,2,3,4] 苏琪[1,2,3,4] 王廷振 王贵新[1,2,3,4] 张正侯 王丽霞[1,2,3,4] 崔芳 

机构地区：[1]辽宁省中日友好医院外科 [2]中国医科大学附属第二临床学院 [3]辽宁中医学院外科 [4]解放军463医院外科

出　　处：《肠外与肠内营养》1998年第4期191-194,共4页Parenteral & Enteral Nutrition

摘　　要：目的：研究精氨酸（Ａｒｇ）对结肠、直肠癌病人的免疫功能和肿瘤细胞增殖活性的影响。方法：结、直肠腺癌病人３０例，随机分为实验组、对照组。实验组每天静脉输注Ａｒｇ２５ｇ，连续３天。检测细胞免疫指标〔Ｔ细胞亚群（ＣＤ３＋、ＣＤ４＋、ＣＤ８＋）、ＮＫ细胞活性、淋巴细胞转化率〕、红细胞免疫指标〔红细胞Ｃ３ｂ受体花环率（ＲＢＣ┐Ｃ３ｂＲＲ）、红细胞免疫复合物花环率（ＲＢＣ┐ＩＣＲ）〕、体液免疫指标（免疫球蛋白和补体）、循环免疫复合物ＣＩＣ的改变，并用免疫组化方法（ＳＰ法）观察肿瘤ＰＣＮＡ表达的变化。结果：实验组ＣＤ４＋、ＣＤ４＋／ＣＤ８＋、ＮＫ细胞活性、ＲＢＣ┐Ｃ３ｂＲＲ均有提高，具有统计学意义；淋巴细胞转化率和ＣＩＣ亦有改善；ＲＢＣ┐Ｃ３ｂＲＲ变化与ＮＫ细胞活性变化之间成直线相关（ｒ＝０．４８０４，Ｐ＜０．０５）。体液免疫指标无显著变化（Ｐ＞０．０５）。ＰＣＮＡ表达显著下降，由５５．８±１３．３％降至４２．６±１１．３％（Ｐ＜０．０１）。结论：短期应用药理剂量的Ａｒｇ可以改善结、直肠癌病人的细胞免疫、红细胞免疫功能，抑制结、直肠癌ＰＣＮＡ表达，但对体液免疫指标无显著影响。提示Ａｒｇ在结、直肠肿瘤的外科营养及辅助治疗中?Objectives:In order to study the effect of arginine on the immune function and tumor cell proliferating activity in patients with colorectal cancer. Methods:Thirty patietns with colorectal cancer were randomly divided into experimental group,in which patients received hydrochloride arginine 25 g/d for three days,and control group.The changes of peripheral blood cellular immune parameters such as T lymphocyte subsets,lymphocyte transformation rate(LTR) and natural killer (NK) cell activity,red blood cell(RBC) immune parameters as RBC C 3bRR,RBC ICR and circulating immune compound(CIC),humoral immune parameters were determined.At the same time,tumor proliferating cell nuclear antigen(PCNA) expression was studied by immunohistochemical method. Results:In experimental group,there were significant improvements on CD4 +,CD4 +/CD8 +,NK cell activity,RBC C 3bRR,especially CD4 + and NK cell activity( P <0.01).LTR and CIC increased only compared with that of pre arginine supplementation.RBC ICR decreased without statistical significance( P >0.05).There was positive correlation between the change of RBC C 3bRR and that of NK cell activity( r =0.4804, P <0.05).The humoral immune parameters did not change.PCNA expression of tumor was inhibited from 55.8% to 42.6% significantly( P < 0.01 ). Conclusions:The short term application of arginine in pharmaceutical dosage could improve cellular immunity and erythrocyte imunity,inhibit tumor cell proliferative activity in patients with colorectal cancer,hut could not affect the humoral immunity.

关 键 词：精氨酸 细胞增殖 免疫功能 PCNA 结肠癌 直肠癌 

分 类 号：R735.35[医药卫生—肿瘤]