肠外营养对乳腺癌患者术后化疗疗效的影响  

Effect of Parenteral Nutrition and Its Influence on Immune Function for Breast Cancer Undergoing Chemotherapy after Surgery

作　　者：周晓云[1] 何奇[1] 邵玉国[1] 籍敏[1] 王杰[1] 韩刚[2] 钟薏[2] 

机构地区：[1]上海交通大学附属国际和平妇幼保健院,200030 [2]上海中医药大学附属曙光医院东院,201203

出　　处：《实用癌症杂志》2014年第6期637-639,共3页The Practical Journal of Cancer

基　　金：国家自然科学基金项目(编号:81001172)

摘　　要：目的探讨肠外营养(PN)对乳腺癌患者术后化疗疗效的影响。方法将92例乳腺癌术后患者随机分为治疗组和对照组,每组各46例,均采用TC化疗方案(环磷酰胺+多西他赛)化疗,对照组采用常规营养支持治疗,治疗组予以谷氨酰胺强化的PN支持治疗,连续2周。比较两组患者的营养指标、免疫指标及不良反应情况。结果化疗后治疗组的营养指标较化疗前下降不明显,但对照组TB、ALB、PA及TF水平及氮平衡较化疗前显著下降(P<0.05);化疗后治疗组CD8、IgM水平有所下降,而对照组CD4、CD8、CD8/CD8和IgA、IgG、IgM水平均较化疗前显著下降(P<0.05);两组均出现恶心呕吐、腹泻及轻度骨髓抑制等不良反应,未见死亡病例及其他严重不良反应。结论对乳腺癌患者术后化疗给予谷氨酰胺强化PN支持,可改善患者的营养状况与免疫功能,减少各种不良反应的发生,改善预后。Objective To explore the effect of parenteral nutrition( PN) for breast cancer patients who received chemotherapy after surgery. Methods 92 breast cancer patients were randomly divided into the treatment group and the control group,each with 46 cases. All the cases were given TC( cytoxan + docetaxel),the control group was treated with normal comprehensive treatment,and the treatment group received PN of glutamine supplementation. All the patients were treated for 2 weeks. The nutritional indicators,immune function and side effects of the 2 groups were compared. Results After chemotherapy,there were no significant decrease in the nutritional indicators in the treatment group than before treatment,while the level of TB,ALB,PA,TF and nitrogen balance in the control group was significantly decreased( P < 0. 05). The level of CD8,IgM in the treatment group decreased slightly after treatment,while the level of CD4,CD8,CD8 /CD8 and IgA,IgG,IgM were all significantly decreased( P <0. 05). The main toxicities in the 2 groups were nausea and vomiting,diarrhea and mild bone marrow suppression,and there were no serious side effects and death cases. Conclusion PN treatment for breast cancer patients during chemotherapy after surgery can improve nutrition status and immune function,reduce the side effects so as to improve prognosis.

关 键 词：乳腺癌 术后化疗 肠外营养 营养指标 免疫指标 

分 类 号：R737.9[医药卫生—肿瘤]