摘要
目的:探讨ω-3多不饱和脂肪酸(PUFA)和谷氨酰胺(Gln)对具有营养风险的晚期肺癌化疗患者的影响。方法:135例晚期肺癌患者随机分为观察组(n=68)和对照组(n=67),所有患者营养风险筛查评分≥3分。观察组化疗同时给予营养支持治疗、ω-3PUFA和Gln,对照组化疗同时给予营养支持治疗。结果:观察组治疗有效率38.2%,对照组为28.4%,2组比较差异无统计学意义(χ2=1.482,P=0.224);常见不良反应为粒细胞减少和恶心呕吐,2组比较差异无统计学意义(Z=1.061、0.096,P>0.05),但观察组有5例出现中性粒细胞减少性发热,对照组有14例,2组比较差异有统计学意义(χ2=5.118,P=0.024);治疗组化疗后免疫学指标IgG、IgA以及CD4+、CD8+、CD4+/CD8+较对照组明显改善(t=20.082、13.585、34.229、22.583、73.021,P均<0.001);2组化疗前后营养学指标体质量、BMI<18.5kg/m2人数、血清白蛋白、前白蛋白变化差异无统计学意义(t=0.858、1.936、1.912、1.833,P均>0.05),但观察组血红蛋白升高更明显(t=19.310,P<0.001)。结论:增加ω-3PUFA和Gln不能提高晚期肺癌患者化疗有效率,但可以明显改善患者的免疫状况。
Aim： To explore the efficacy of the combination of ω-3 polyunsaturated fatty acids （PUFA） and glutamine（Gln） with chemotherapy on patients with advanced primary lung cancer and high nutritional risk.Methods： A total of 135 patients with advanced lung cancer and NRS2002 score ≥ 3 were randomly allocated into two groups： the trail group（n=68） and the control group（n=67） .The trail group received nutritional support treatment,ω-3PUFA and Gln in combination with chemotherapy.The control group received nutrition support therapy combined with chemotherapy.Results： RR was 38.2% in the trail group and 28.4% in the control group,and there was no statistic difference between the 2 groups （χ2=1.482,P=0.224） .The common adverse reactions were neutropenia,nausea and vomiting,and there was no statistic difference between the 2 groups（Z=1.061,0.096,P0.05） ; there were 5 patients with neutropenic fever in trail group and 14 in control group,and there was a statistic difference between the 2 groups（χ2=5.118,P=0.024） .Compared with control group,the changes of immunologic indicators before and after chemotherapy such as IgG,IgA,CD4＋, CD8＋,and CD4＋/CD8＋in the trail group improved（t=20.082,13.585,34.229,22.583,73.021,P0.001） .The changes of hemoglobin before and after chemotherapy of the 2 groups had significant difference （t=19.310,P0.001） .Conclusion： ω-3PUFA and Gln application in patients with chemotherapy could not improve the response rate of chemotherapy,but could significantly improve the immune status of patients.
出处
《郑州大学学报（医学版）》
CAS
北大核心
2013年第4期536-539,共4页
Journal of Zhengzhou University(Medical Sciences)
