肠外营养联合化疗对消化道恶性肿瘤患者营养状况和免疫功能的影响  

Effects of parenteral nutrition in combination with chemotherapy on the nutritional status and immunity function in patients with malignant tumors of digestive tract

作　　者：邢士超[1] 田炳如[1] 夏永明[1] 陈幼芬[1] 陈曦[1] 

机构地区：[1]余姚市人民医院肿瘤内科,浙江省余姚315400

出　　处：《中国基层医药》2015年第16期2420-2423,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省余姚市人民医院院级课题（YJY02A）

摘　　要：目的：研究肠外营养联合化疗对消化道恶性肿瘤患者营养状况和免疫功能的影响。方法将100例消化道恶性肿瘤患者作为研究对象，采用随机数字表法分为对照组和治疗组，每组50例。对照组在化疗期间未给予特殊处理，观察组在入院后根据胃肠功能给予肠外营养支持，统计4个疗程后的营养指标：血清白蛋白（serumalbumin，ALB）、前白蛋白（prealbumin，PA）、转铁蛋白（thansferrin，TF），免疫功能指标：免疫球蛋白 A（immunoglobulin A，IgA）、免疫球蛋白 G（immunoglobulin G，IgG）、免疫球蛋白 M（immunoglobulin M，IgM）， T 淋巴细胞亚群及 T 细胞免疫功能检测指标：CD ＋4、CD ＋8以及 CD ＋4／CD ＋8的比值。结果营养指标组间比较，术前和第4个疗程后差异无统计学意义（t ＝0．093，P ＞0．05）。组间比较，第4个疗程后观察组 Tf 和 PA 水平与对照组比较差异均有统计学意义（t ＝3．302，P ＜0．05）；术后第4个疗程后，IgM指标在两组差异有统计学意义（t ＝4．135，P ＜0．05），经组内比较观察组三者的指标水平均高于术前指标水平，差异有统计学意义（t ＝3.426，P ＜0．05）；术后第4个疗程后，观察组的 CD ＋4水平明显高于对照组，差异有统计学意义（t ＝0．087，P ＜0．05），组间比较两组在第4个疗程后 CD ＋4／CD ＋8水平均比术前改善（t ＝3．359，P ＜0．05），组内比较对照组第4个疗程后 CD ＋8明显低于术前（t ＝3．265，P ＜0．05）。结论肠外营养联合化疗能改善消化道恶性肿瘤患者的营养状况及提高机体的免疫功能。Objective To study the effect of parenteral nutrition combined with chemotherapy on nutritional status and immunity function of patients with gastrointestinal cancer.Methods 100 gastrointestinal cancer patients were treated as research subjects,and they were randomly divided into the treatment group and the control group.The control group was not given special treatment during chemotherapy,while the observation group patients were given nutritional support according to the gastrointestinal function after admission.The nutrition indicators of ALB,TF,PA, immune function parameters IgA,IgG,IgM,T lymphocyte subsets and T cell immune function indicators（CD ＋4 ,CD ＋8 and CD ＋4 /CD ＋8 ）were counted after the four courses.Results There was no significant difference between the preop-erative and after fourth courses of treatment（t =0.093,P 〉0.05）between the two groups in nutrition.Within group comparisons,data of Tf and PA levels in the observation group were significant different compared with the control group after fourth courses of treatment （t =3.302,P 〈0.05）.After the first 4 postoperative course,IgM index was statistically significant（t =4.135,P 〈0.05）different between the two groups,three indicators within the observation group were higher than the preoperative level indicators,the difference was statistically significant（t =3.426,P 〈0.05）.After the first 4 postoperative course,the CD ＋4 level was significantly higher in the observation group,the difference was statistically significant（t =0.087,P 〈0.05）.Comparison between the two groups after the first four courses,the CD ＋4 /CD ＋8 level was higher than that of preoperative patients with a significant difference（t =3.359,P 〈0.05）.Intra -group comparison of the control group,four courses of CD ＋8 was significantly lower than that of the pre-operative patients（t =3.265,P 〈0.05）.Conclusion Parenteral nutrition combined with chemotherapy can improve the nutritional status of patients with malignant tumors

关 键 词：胃肠外营养 抗肿瘤联合化疗方案 胃肠肿瘤 营养状况 免疫 

分 类 号：R735[医药卫生—肿瘤]