ω-3多不饱和脂肪酸和谷氨酰胺对具有营养风险的晚期肺癌化疗患者的影响  

Efficacy of combination of ω-3 polyunsaturated fatty acids and glutamine with chemotherapy on patients with advanced primary lung cancer and high nutritional risk

作　　者：韩东景[1] 赵楠[1] 薛永飞[2] 沈艳丽[2] 马慧利[2] 张蕾[2] 

机构地区：[1]南阳市中心医院营养科,南阳473001 [2]南阳市中心医院肿瘤科,南阳473001

出　　处：《郑州大学学报（医学版）》2013年第4期536-539,共4页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:探讨ω-3多不饱和脂肪酸(PUFA)和谷氨酰胺(Gln)对具有营养风险的晚期肺癌化疗患者的影响。方法:135例晚期肺癌患者随机分为观察组(n=68)和对照组(n=67),所有患者营养风险筛查评分≥3分。观察组化疗同时给予营养支持治疗、ω-3PUFA和Gln,对照组化疗同时给予营养支持治疗。结果:观察组治疗有效率38.2%,对照组为28.4%,2组比较差异无统计学意义(χ2=1.482,P=0.224);常见不良反应为粒细胞减少和恶心呕吐,2组比较差异无统计学意义(Z=1.061、0.096,P>0.05),但观察组有5例出现中性粒细胞减少性发热,对照组有14例,2组比较差异有统计学意义(χ2=5.118,P=0.024);治疗组化疗后免疫学指标IgG、IgA以及CD4+、CD8+、CD4+/CD8+较对照组明显改善(t=20.082、13.585、34.229、22.583、73.021,P均<0.001);2组化疗前后营养学指标体质量、BMI<18.5kg/m2人数、血清白蛋白、前白蛋白变化差异无统计学意义(t=0.858、1.936、1.912、1.833,P均>0.05),但观察组血红蛋白升高更明显(t=19.310,P<0.001)。结论:增加ω-3PUFA和Gln不能提高晚期肺癌患者化疗有效率,但可以明显改善患者的免疫状况。Aim： To explore the efficacy of the combination of ω-3 polyunsaturated fatty acids （PUFA） and glutamine（Gln） with chemotherapy on patients with advanced primary lung cancer and high nutritional risk.Methods： A total of 135 patients with advanced lung cancer and NRS2002 score ≥ 3 were randomly allocated into two groups： the trail group（n=68） and the control group（n=67） .The trail group received nutritional support treatment,ω-3PUFA and Gln in combination with chemotherapy.The control group received nutrition support therapy combined with chemotherapy.Results： RR was 38.2% in the trail group and 28.4% in the control group,and there was no statistic difference between the 2 groups （χ2=1.482,P=0.224） .The common adverse reactions were neutropenia,nausea and vomiting,and there was no statistic difference between the 2 groups（Z=1.061,0.096,P0.05） ; there were 5 patients with neutropenic fever in trail group and 14 in control group,and there was a statistic difference between the 2 groups（χ2=5.118,P=0.024） .Compared with control group,the changes of immunologic indicators before and after chemotherapy such as IgG,IgA,CD4＋, CD8＋,and CD4＋/CD8＋in the trail group improved（t=20.082,13.585,34.229,22.583,73.021,P0.001） .The changes of hemoglobin before and after chemotherapy of the 2 groups had significant difference （t=19.310,P0.001） .Conclusion： ω-3PUFA and Gln application in patients with chemotherapy could not improve the response rate of chemotherapy,but could significantly improve the immune status of patients.

关 键 词：肺肿瘤 营养风险 免疫调节营养 Ω-3多不饱和脂肪酸 谷氨酰胺 

分 类 号：R734.2[医药卫生—肿瘤]