摘要
目的:观察谷氨酰胺(Gln)强化的全肠外营养(TPN)对妇科恶性肿瘤患者术后免疫功能的影响。方法:60例手术治疗的妇科恶性肿瘤患者,随机分为实验组和对照组各30例,营养支持疗程为7天。采用全营养混合液通过中心静脉输注,均为等氮等热量。对照组给予一般的肠外营养支持,治疗组给予谷氨酰胺为底物的肠外营养支持。两组患者均于术前、术后营养支持7天后检测清蛋白(ALB)、前清蛋白(PAB)和转铁蛋白(TRF)以及IgG、IgA和IgM和T淋巴细胞亚群CD4+、CD8+及CD4+/CD8+值。结果:实验组免疫营养支持7天后PAB和TRF较治疗前及对照组均明显上升(P<0.05);IgA和IgG均高于营养支持前和对照组(P<0.05),T淋巴细胞亚群CD4+百分比和CD4+/CD8+值均高于营养支持前和对照组(P<0.05)。结论:以谷氨酰胺为底物的全肠外免疫营养支持可改善妇科肿瘤患者围术期蛋白质合成和免疫功能。
Objective： To evaluate the effect of glutamine （Gin） enriched total parenteral nutrition （TPN） on immunologic function after operation of gynecological malignant tumors patients, methods：Sixty patients with gynecological malignant tumors patients after operation were randomized into experimental group and control group. From the first day after operation, TPN was infused to the patients with equal calorie and equal nitrogen by central or peripheral vein for 7 days. Tests of the protein metabolism status （ALB, PAB and TRF ） and immunologic function （ IgG, IgA, IgM, CD4^＋, CD8^＋ and- CD4^＋/CD8^＋ ） were performed preoperatively and on the day before operation, the 1st day and the 7th day after operation respectively. Ressult TS： Experimental group had improved the protein metabolism status with increased PAB and TRF as compared with routine group at the 1 st and the 7 th day after operation （P 〈 O. 05 ）. Experimental group had improved immunologic function with increased IgG, IgA, CD^＋4 and CD4^＋/CD8^＋ as compared with routine group at the 1 st and the 7 th day after operation （ P 〈 0. 05 ）. Conclusion ： Gin enriched TPN could effectively ameliorate the protein metabolism status and immunologic function after operation of gynecological malignant tumors patients.
关键词
妇科恶性肿瘤
谷氨酰胺
全肠外营养
免疫功能
Gynecological malignant tumors
Glutamine
Total parenteral nutrition
Immunologic function
