结构脂肪乳对消化道肿瘤术后患者急性炎性反应和免疫功能的影响  

Effect of structured lipid emulsion on acute inflammatory reaction and immunologic function in gastrointestinal cancer patients after operation

作　　者：吕清泉[1,2] 童仕伦[1] 

机构地区：[1]武汉大学人民医院,湖北武汉430060 [2]湖北省武汉市汉口医院,湖北武汉430012

出　　处：《现代中西医结合杂志》2014年第9期923-925,928,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨结构脂肪乳对消化道肿瘤术后患者急性炎性反应和免疫功能的影响。方法选取消化道肿瘤术后患者80例,按分层抽样法随机分为结构脂肪乳组(观察组)和物理混合的中/长链脂肪乳组(对照组),每组40例,于术后第1—6天接受等氮、等热量的肠外营养。对比观察2组患者术后一般情况,分别于术前及术后1,7 d检测血清炎性反应指标和免疫功能状况。结果在进行6 d的肠外营养以后,2组患者生命体征、血常规、肝肾功能、血脂等均在正常范围,观察组术后感染相关并发症发生率较对照组低,术后住院时间较对照组短,但无显著性差异(P均>0.05)。2组术后1 d外周血前列腺素E2(PGE2)、C反应蛋白(CRP)、α1-抗胰蛋白酶(α1-AT)和纤维蛋白原(FIB)浓度较术前明显升高,随后逐渐下降,观察组术后7 d外周血PGE2、CRP、α1-AT和FIB浓度明显低于对照组(P均<0.05);2组术后1 d外周血中IgG、IgA、IgM、CD3+、CD4+、CD8+水平均有不同程度下降,随后逐渐回升,观察组术后7 d外周血IgG、CD3+、CD4+水平较对照组明显升高(P均<0.05)。结论结构脂肪乳能减轻消化道肿瘤术后患者免疫抑制,减轻炎性反应,改善机体免疫功能。Objective It is to approach the influence of structured lipid emulsion on acute inflammatory reaction and immunologic function in gastrointestinal cancer patients after operation.Methods 80 postoperative patients with gastrointestinal cancer were collected and randomly divided into structured lipid emulsion group（observation group） and physic mixture of medium-chain/long-chain triglycerides group（control group） with 40 cases each by stratified sampling method.Both groups received isonitrogenous and isocaloric parenteral nutrition for 6 days after operation.The general conditions after operation were compared between groups.Acute inflammatory reaction and immunologic function were measured before and the 1 st day and 7th day after operation.Results After 6 days parenteral nutrition,the vital sign data,blood routine,liver and renal function,blood fat etc was normal in two groups.There was no significant difference in the incidence of postoperative infection complication and hospitalization duration between observation group and control group （all P ＞ 0.05）.The serum levels of prostaglandin G2 （PGE2）,C reactive protein （CRP）,α1-antitrypsin （α1-AT）,fibrinogen （Fib） on the 1st day after operation in two groups were significantly higher than those before operation,then gradually felling.The serum levels of PGE2,CRP,α1-AT,Fib on the 7th day after operation in observation group were lower than those in control group （all P ＜ 0.05）.The serum levels of IgG,IgA,IgM,CD3 ＋,CD4 ＋ and CD8 ＋ on the 1 st day after operation in two groups were decreased,then gradually increasing.The serum levels of IgG,CD3 ＋,CD4 ＋ were higher in observation group than those in control group （all P ＜0.05）.Conclusion Structured lipid emulsion can reduce immunological suppression,and improve the immune function.

关 键 词：脂肪乳剂 静脉注射用 肿瘤 系统性炎症反应综合征 免疫功能 

分 类 号：R735[医药卫生—肿瘤]