营养及化疗对肿瘤患者血清微量元素和免疫功能的影响  

Effects of nutrition and chemotherapy on serum trace elements and immune function in cancer patients

作　　者：林云 陈志刚[1] 曹阳[2] 万姗 唐求[1] LIN Yun;CHEN Zhi-gang;CAO Yang;WAN Shan;TANG Qiu(Department of Oncology,Wuhan Central Hospital,Wuhan 430014,Hubei,China;Clinical Laboratory,Wuhan Central Hospital,Wuhan 430014,Hubei,China;Department of Endocrinology,Wuhan Central Hospital,Wuhan 430014,Hubei,China)

机构地区：[1]武汉市中心医院肿瘤科,武汉430014 [2]武汉市中心医院检验科,武汉430014 [3]武汉市中心医院内分泌科,武汉430014

出　　处：《肿瘤代谢与营养电子杂志》2019年第1期66-69,共4页Electronic Journal of Metabolism and Nutrition of Cancer

摘　　要：目的探讨肿瘤患者化疗后血清微量元素及免疫功能的变化,以及肠内营养支持对上述测定指标的影响。方法 选择2018年3月至5月进入武汉市中心医院化疗的肿瘤患者19例,年龄为18~70岁;KPS评分≥60。随机分为两组:9例患者化疗期间行肠内营养干预,10例患者未进行营养干预。在化疗前后分别测定血清微量元素和外周血淋巴细胞亚群,并进行统计学分析。结果未经营养干预的患者化疗后血清锰含量比化疗前显著减低(P=0.004),化疗后血清铅呈现临界水平降低(P=0.057);行营养干预的患者血清锌含量显著降低(P=0.013),外周血中NK细胞比例在化疗后呈临界水平降低(P=0.059),而CD4^+/CD8^+之比在化疗后呈临界水平升高(P=0.057)。结论化疗及营养干预对血清微量元素浓度有一定的作用;营养干预对外周血T细胞的分布有一定的影响,表现为NK细胞比例在化疗后有降低趋势,CD4^+/CD8^+比值有升高趋势。由于病例数较少以及营养干预时间较短,因此有必要增加病例数以及延长营养干预时间并做进一步深入研究。Objective To investigate the changes of serum trace elements and immune function in patients with cancer after chemotherapy,and investigate the effect of enteral nutrition on those as well.Methods Between March and May of 2018,19 cancer patients,aged 18~70 years,with KPS score equals or more than 60,were enrolled and randomly divided into two groups.One of them with 9 subjects received enteral nutrition intervention during chemotherapy;another group with 10 subjects received chemotherapy only without enteral nutrition intervention.Serum trace elements and peripheral blood lymphocyte subsets were measured before and after chemotherapy.A paired t-test with two-tailed was used to compare two population means by SPSS 18.00,and the significant difference between two groups was considered when P<0.05.Results The serum manganese concentration in patients without nutritional intervention after chemotherapy was significantly lower than that before chemotherapy(P=0.004),the serum lead was borderline lower after chemotherapy compared with that before chemotherapy(P=0.057);the serum zinc content in patients with nutritional intervention after chemotherapy was significantly lower than that before chemotherapy,and the NK cell percentage in peripheral blood was borderline decreased in patients with nutritional intervention after chemotherapy compared with that before chemotherapy,while the ratio of CD4+/CD8+was borderline increased after chemotherapy compared with that before chemotherapy(P=0.057).Conclusion Chemotherapy and nutrition intervention have certain effects on the concentration of serum trace elements,nutrition intervention has borderline influence on the distribution of peripheral blood T cells,which shows that the proportion of NK cells was borderline decreased after chemotherapy and the ratio of CD4^+/CD8^+was borderline increased after chemotherapy.Because the number of cases is limited and the duration of nutrition intervention is short,it is necessary to increase the number of cases and prolong the time of nutr

关 键 词：锰 铅 锌 NK细胞 CD4^+/CD8^+比值 肿瘤 

分 类 号：R730.5[医药卫生—肿瘤]