术中输注精氨酸对胃肠道肿瘤患者围术期免疫炎症反应的调节作用  

Regulatory effect of intraoperative infusion of arginine on perioperative immune inflammatory response in patients with gastrointestinal tumors

作　　者：罗俊 叶琦刚[1] Luo Jun;Ye Qigang(Department of Anesthesiology and Surgery,Taizhou First People′s Hospital,Taizhou,Zhejiang 318020,China)

机构地区：[1]台州市第一人民医院麻醉手术科,浙江台州318020

出　　处：《中国药物与临床》2024年第21期1379-1384,共6页Chinese Remedies & Clinics

基　　金：浙江省台州市科技计划项目(1902ky55)。

摘　　要：目的分析术中输注精氨酸对胃肠道肿瘤患者围术期免疫炎症反应的调节作用研究。方法2020年10月至2023年9月,选取浙江省台州市第一人民医院就诊的100例胃肠道肿瘤患者,用随机数字表法将其分为对照组及观察组,每组50例,对照组术中输注葡萄糖,观察组术中输注精氨酸,观察2组患者免疫炎症反应等情况。结果术后7d,2组患者总蛋白(TP)、前白蛋白(PA)、白蛋白(ALB)水平均升高(P<0.05),观察组比对照组升高明显(P<0.05);对照组及观察组术后7 d IgG水平分别为(9.5±1.7)g/L、(10.6±1.8)g/L,组间比较差异有统计学意义(t=3.216,P=0.002),IgA水平分别为(2.8±0.4)g/L、(3.3±0.6)g/L,组间比较差异有统计学意义(t=4.598,P<0.01),IgM水平分别为(1.79±0.26)g/L、(2.22±0.31)g/L,组间比较差异有统计学意义(t=7.515,P<0.01);对照组及观察组术后7 d CD4^(+)水平分别为(45±4)%、(52±5)%,组间比较差异有统计学意义(t=7.175,P<0.01),CD8^(+)水平分别为(28.4±2.5)%、(23.4±2.2)%,组间比较差异有统计学意义(t=10.440,P<0.01),CD4^(+)/CD8^(+)水平分别为1.59±0.45、2.23±0.52,组间比较差异有统计学意义(t=6.581,P<0.01);术后7 d,2组CD4^(+)、CD4^(+)/CD8^(+)水平升高(P<0.05),CD8^(+)水平降低(P<0.05),观察组与对照组相比变化更明显(P<0.05);对照组及观察组术后7 d IL-2水平分别为(56±6)ng/L、(63±7)ng/L,组间比较差异有统计学意义(t=6.405,P<0.01),IL-10水平分别为(46.4±4.6)ng/L、(35.6±4.0)ng/L,组间比较差异有统计学意义(t=12.520,P<0.01),TNF-α水平分别为(141±12)ng/L、(158±14)ng/L,组间比较差异有统计学意义(t=6.619,P<0.01),与术前相比,术后7 d 2组患者IL-2、TNF-α水平升高(P<0.05),IL-10水平降低(P<0.05),观察组与对照组相比降低明显(P<0.05);与对照组比较,观察组切口感染、腹腔感染、肺部感染及泌尿系感染等感染例数降低,观察组总感染率(6.0%)低于对照组(20.0%),组间差异有统计学意义(χ^(2)=4.332,P=0.037)ObjectiveTo investigate the regulatory effect of intraoperative infusion of arginine on perioperative immune inflammatory response in patients with gastrointestinal tumors.MethodsA total of 100 patients with gastrointestinal tumors who were treated in the Taizhou First People′s Hospital from October 2020 to September 2023 were selected and divided into a control group and an observation group according to the random number table method,with 50 patients in each group.The control group received intraoperative glucose infusion,while the observation group received intraoperative arginine infusion.The immune and inflammatory responses of the two groups were observed and compared.ResultsOn the 7th day after surgery,the levels of TP,PA,and ALB in both groups were significantly increased(P<0.05),and the observation group showed a significant increase compared to the control group(P<0.05);On the 7th day after surgery,the IgG levels in the control group and observation group were(9.5±1.7)g/L and(10.6±1.8)g/L,respectively.The difference between the groups was statistically significant(t=3.216,P=0.002),and the IgA levels were(2.8±0.4)g/L and(3.3±0.6)g/L,respectively.The difference between the groups was statistically significant(t=4.598,P<0.01).The IgM levels were(1.79±0.26)g/L and(2.22±0.31)g/L,respectively,The difference between groups was statistically significant(t=7.515,P<0.01);The CD4^(+)levels in the control group and the observation group were(45±4)%and(52±5)%,respectively,7 days after surgery.The difference between the groups was statistically significant(t=7.175,P<0.01),and the CD8^(+)levels were(28.4±2.5)%and(23.4±2.2)%,respectively.The difference between the groups was statistically significant(t=10.440,P<0.01),while the CD4^(+)/CD8^(+)levels were(1.59±0.45)and(2.23±0.52),respectively.The difference between the groups was statistically significant(t=6.581,P<0.01);On the 7th day after surgery,the levels of CD4^(+)and CD4^(+)/CD8^(+)in both groups were significantly increased(P<0.05),while the levels

关 键 词：精氨酸 胃肠肿瘤 炎症 

分 类 号：R735[医药卫生—肿瘤]