肠内免疫营养对食管癌化疗患者治疗的影响  

Effects of enteral immunonutrition on the treatment in patients with esophageal cancer receiving chemotherapy

作　　者：谢兰[1] 刘杰[1] 姚勇[1] XIE Lan LIU Jie YAO Yong(Fifth ward, Department of Gastroenterology, Suining Central Hospital, Suining 629000, Chin)

机构地区：[1]四川省遂宁市中心医院消化中心五病区,遂宁629000

出　　处：《中国肿瘤临床与康复》2017年第5期579-582,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨肠内免疫营养对食管癌化疗患者治疗效果、营养状况及免疫功能的影响。方法选取2014年6月至2016年5月间遂宁市中心医院收治的76例紫杉醇联合顺铂(TP方案)治疗的食管癌患者,采用随机数表法分为观察组(肠内免疫营养)与对照组(肠外营养),每组38例。对比两组患者的治疗效果、治疗前后营养状况及免疫功能。结果观察组患者治疗总有效率为60.5%,明显高于对照组患者的36.8%,两组比较,差异有统计学意义(P<0.05)。两组患者治疗前营养状况及免疫功能相关指标比较,差异均无统计学意义(均P>0.05)。治疗后观察组患者上臂围(AMC)、三头肌皮褶厚度(TSF)、血红蛋白(Hb)、血清白蛋白(Alb)、前白蛋白(PA)、转铁蛋白(TRF)指标均明显高于对照组患者,两组比较,差异均有统计学意义(均P<0.05)。治疗后两组患者免疫功能CD8^+水平无明显差别,但观察组患者CD3^+、CD4^+和CD4^+/CD8^+指标均明显高于对照组患者,两组比较,差异均有统计学意义(均P<0.05)。结论肠内免疫营养能有效改善食管癌患者TP方案治疗的营养状况和免疫功能,提高治疗效果。Objective To investigate the effect of enteral immunonutrition on the therapeutic effica- cy, nutritional status and immune function in patients with esophageal cancer treated with chemotherapy. Methods Thirty-six patients with esophageal cancer treated with paclitaxel combined cisplatin （TP regi- men） from June 2014 to May 2016 were selected and divided into an observation group （ enteral immunonut- rition） and a control group （parenteral nutrition） according to a random number table, with 38 patients in each group. The therapeutic efficacy nutritional status and immune function were compared between the two groups before and after treatment. Results The overall efficacy rate was 60. 5% in the observation group which was significantly higher than 36. 8% of the control group （ P 〈 0. 05 ）. There were no significant differences in the indexes of nutritional status and immune function between the two groups before treatment （P 〉0.05）. The levels of arm muscle circumference （AMC） , triceps skinfold thickness （TSF） , hemoglo- bin （Hb）, albumin （Alb）, prealbumin （PA） and transferrin （TRF） were significantly higher in the obser- vation group than in the control group after treatment （ P 〈 0. 05 ）. There was no significant difference in the level of CD8＋ between the two groups （ P 〉 0. 05 ） but the levels of CD3 ＋ , CD4＋ and CD4＋/CD8 ＋ were significantly higher in the observation group than in the control group （ all P 〈 0. 05 ）. Conclusion Enteral immunonutrition can effectively improve the nutritional status and immune function and therapeutic efficacy in patients with esophageal cancer treated with TP regimen.

关 键 词：肠内免疫营养 紫杉醇 食管肿瘤 营养风险 

分 类 号：R459.3[医药卫生—治疗学] R735.1[医药卫生—临床医学]