丙氨酰谷氨酰胺联合ω-3鱼油脂肪乳肠外营养支持对结直肠癌患者术后营养状况和免疫功能的影响  

Effectsof Alanyl Glutamine Combined withω-3 Polyunsaturated Fatty Acid Parenteral Nutritional Support on Postoperative Nutritional Status and Immune Function in Patients with Colorectal Cancer

作　　者：吴玉珠[1] 林建安[1] 陈文发[1] WU Yuzhu;LIN Jianan;CHEN Wenfa(The Second Affiliated Hospital of Fujian Medical University,Quanzhou Fujian 362000,China)

机构地区：[1]福建医科大学附属第二医院,福建泉州362000

出　　处：《药品评价》2021年第15期920-923,共4页Drug Evaluation

摘　　要：目的:研究丙氨酰谷氨酰胺联合ω-3鱼油脂肪乳(ω-3 PUFA)肠外营养支持对结直肠癌患者术后营养状况和免疫功能的影响。方法:选择2018年8月至2019年8月在福建医科大学附属第二医院行结直肠癌根治术的患者151例,随机数字表法分为A组(50例)、B组(52例)、C组(49例),A组术后采用常规肠外营养,B组术后采用常规肠外营养+ω-3 PUFA,C组采用常规肠外营养+ω-3 PUFA+丙氨酰谷氨酰胺。观察各组患者术前、术后1周营养学指标、免疫学指标以及术后不良反应发生率和术后住院时间。结果:术后1周白蛋白(ALB)、血红蛋白(HGB)、前白蛋白(TF)、转铁蛋白(PA)均较术前降低(P<0.05),且C组高于B组,B组高于A组(P<0.05);术后1周观察组免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、CD4^(+)、CD8^(+)较术前均降低,但C组高于B组,B组高于A组(P<0.05);C组患者术后住院时间、术后不良反应总发生率低于A组和B组,差异有统计学意义(P<0.05)。结论:丙氨酰谷氨酰胺联合ω-3 PUFA肠外营养支持有助于结直肠癌患者术后改善营养状况及免疫功能,缩短住院时间,减少不良反应总发生率。Objective:To study the effect of alanyl glutamine combined withω-3 fish oil fat emulsion(ω-3 PUFA)parenteral nutrition support on postoperative nutritional status and immune function in patients with colorectal cancer.Methods:Choice in August 2018-August 2019 in The Second Affiliated Hospital of Fujian Medical University 151 cases of patients with colorectal cancer radical,its randomly divided into group A(50 cases)and group B(52 cases),C group(49 cases),postoperative using conventional parenteral nutrition group A,group B after the conventional parenteral nutrition+ω-3 PUFA,the conventional parenteral nutrition group C+ω-3 PUFA+C ammonia acyl glutamine.Nutritional indexes,immunological indexes,incidence of postoperative adverse reactions and postoperative hospital stay were observed in each group before and 1 week after surgery.Results:One week after surgery,albumin(ALB),hemoglobin(HGB),pre-albumin(TF)and transferrin(PA)were lower than those before surgery(P<0.05),and group C was higher than group B,and group B was higher than group A(P<0.05).One week after operation,immunoglobulin G(IgG),immunoglobulin A(IgA),immunoglobulin M(IgM),CD4^(+)and CD8^(+)in observation group were decreased compared with those before operation,but those in group C were higher than those in group B,and those in group B were higher than those in group A(P<0.05).The postoperative hospital stay and the total incidence of postoperative adverse reactions in group C were lower than those in group A and group B,and the difference was statistically significant(P<0.05).Conclusion:Alanyl glutamine combined withω-3 PUFA parenteral nutrition support can improve postoperative nutritional status and immune function,shorten the length of hospital stay,and reduce the overall incidence of adverse reactions in patients with colorectal cancer.

关 键 词：胃肠外营养 丙氨酰谷氨酰胺 Ω-3鱼油脂肪乳 结直肠癌 营养状况 免疫 

分 类 号：R459.3[医药卫生—治疗学] R735.34[医药卫生—临床医学]