双歧杆菌三联活菌对胃癌部分切除患者术后炎症因子、免疫和营养状态的影响  

Effects of viable Tri-Bifidobacteria on inflammatory factors,immunity and nutritional status of patients with gastric cancer after partial resection

作　　者：张璐[1] 孙元水[2] 何天柱 ZHANG Lu;SUN Yuanshui;HE Tianzhu(Zhejiang Chinese Medical University,Shaoxing, Zhejiang 310053,China)

机构地区：[1]浙江中医药大学,浙江绍兴310053 [2]浙江省立同德医院胃肠外科,310012

出　　处：《中国微生态学杂志》2019年第6期680-683,688,共5页Chinese Journal of Microecology

基　　金：浙江省科学技术厅基金(2017F30045);浙江省中医药科技计划项目(2018ZZ004)

摘　　要：目的探究胃癌部分切除术后补充双歧杆菌三联活菌对患者营养状态、炎症和免疫因子的影响,为肿瘤术后患者营养治疗支持提供建议。方法选取2017年1月至2018年12月在我院行部分胃癌切除术的早期胃癌患者114例,采用随机数表法分为对照组(57例)与观察组(57例),两组患者于术后3~5 d开始进食,观察组在此基础上使用双歧杆菌三联活菌片,3粒/次,3次/日,口服,疗程14 d。对比两组治疗前后炎症因子水平(ELISA法测定外周血IL-2、IL-6及TNF-α水平)、免疫细胞水平(流式细胞仪测定外周血CD4^+、CD8^+、CD4^+/CD8^+水平)、营养状态(蛋白质测定仪测定外周血白蛋白和总蛋白水平)及治疗不良反应。结果治疗前两组IL-2、IL-6及TNF-α水平无明显差异(t=1.861,0.744,1.489;P=0.064,0.457,0.138),治疗后两组上述指标均较治疗前显著下降,其中观察组治疗后上述指标水平显著低于对照组(t=5.784,6.153,8.457;均P<0.05);治疗前两组CD4^+、CD8^+、CD4^+/CD8^+水平无明显差异(t=1.301,1.084,0.542;P=0.198,0.283,0.590),治疗后两组CD4^+、CD4^+/CD8^+均较治疗前显著提高,CD8^+显著下降,其中观察组治疗后CD4^+、CD4^+/CD8^+水平显著高于对照组(t=5.205,3.904;均P<0.05),CD8^+显著低于对照组(t=6.507;P<0.05);治疗前两组白蛋白及总蛋白水平无明显差异(t=1.301,0.651;P=0.198,0.518),治疗后两组上述水平均较治疗前显著提高,其中观察组治疗后白蛋白及总蛋白水平显著高于对照组(t=13.664,8.590;均P<0.05);两组不良反应发生率无明显差异(5.26%vs 10.53%;χ^2=1.086,P=0.297)。结论胃癌部分切除术后补充益生菌可有效调节患者的炎症和免疫状态,显著改善营养状况。Objective To explore the effects of viable Tri-Bifidobacteria on the inflammatory factors,immunity and nutritional status of patients with gastric cancer after partial resection and provide evidence for nutritional support for postoperative patients with cancer. Methods One hundred and fourteen patients with early gastric cancer who underwent partial gastrectomy in our hospital from January 2017 to December 2018 were selected and divided into control group(57 cases)or observation group(57 cases)randomly.The patients in both groups started eating 3 to 5 days after surgery.On this basis,the observation group was given viable Tri-Bifidobacteria orally,3 capsules tid for 14 days.The levels of IL-2,IL-6 and TNF-α in peripheral blood(measured by ELISA),levels of CD4^+,CD8^+ and CD4^+/CD8^+ levels in peripheral blood(by flow cytometry),nutrition status(levels of albumin and total protein in peripheral blood by protein analyzer)and adverse reactions before and after the treatment were compared between the two groups. Results There were no significant differences in the levels of IL-2,IL-6 and TNF-α between the two groups before treatment(t=1.861,0.744,1.489;P=0.064,0.457,0.138);the levels of the above indicators significantly decreased in both groups after treatment(all P<0.05),and those in observation group were significantly lower than those in control group respectively(t=5.784,6.153,8.457;all P<0.001).There were no significant differences in the levels of CD4^+,CD8^+ and CD4^+/CD8^+ between the two groups before treatment(t=1.301,1.084,0.542;P=0.198,0.283,0.590).After treatment,the levels of CD4^+ and CD4^+/CD8^+ in both groups were significantly higher,while that of CD8^+ was significantly lower,with the levels of CD4^+ and CD4^+/CD8^+ in observation group significantly higher(t=5.205,3.904;all P<0.001)while that of CD8^+ significantly lower than in control group(t=6.507,P=0.000)respectively.There were no significant differences in the levels of albumin and total protein between the two groups before treatment(t=1

关 键 词：益生菌 胃癌 免疫 营养 

分 类 号：R735.2[医药卫生—肿瘤]