【摘要】 目的评价谷氨酰胺、精氨酸强化的肠外营养(PN)对食管癌患者手术后免疫功能和应激反应的影响。方法筛选食管癌手术病人60例,随机分成4组:单纯静脉营养(Rt)组,谷氨酰胺强化组(Glu组),精氨酸强化组(Arg组),谷氨酰胺-精氨酸联合强化组(Glu-Arg组)。术后1～7d给予等氮量、等热量静脉营养,精氨酸强化组给与Arg 30g.d-1,谷氨酰胺强化组给予Glu 0.35g.kg-1.d-1,联合组加入Arg和Glu量与前两组相同。分别于术前,术后d1、d8检测IgA、IgG、IgM、CRP、TNF-α。结果术后d8与d1相比IgA、IgG、IgM升高,CRP、TNF-α下降;实验组指标与Rt相比有显著性差异(P<0.05)。结论食管癌手术病人后应用Arg、Glu增强的PN与常规PN相比能较好地恢复免疫功能,降低全身炎症反应;与单用Arg或Glu增强的PN相比,联合应用效果更好。更多还原

【Abstract】 【Objective】 To determine the effect of Arginine and Glutamine enriched PN on immune function and stringent status following esophageal cancer surgery.【Methods】 60 patients who underwent the same elective operation for thoracic esophgeal carcinoma were prospectively and equally randomized into 4 groups: Glu group,Arg group,Arg-Glu group and standard PN group.PN was infused to all patients with equal calorie and equal nitrogen by central vein during the immediate 7d after operation.30g·d-1 Arginine was added into PN in the Arg group,0.35g·kg-1·d-1 Glu enriched PN in the Glu group,while in the Arg-Glu group the doses of Arg and Glu were equal to those in the Arg group and Glu group.On preoperation and on postoperative day 1,8,IgA,IgM,IgG,CRP and TNF-αwere determined.【Results】 On the eighth day of postoperation,all indicators of Arg group,Glu group and Arg-Glu group were significantly better than routine group(P<0.05),These data of Arg-Glu group were better than those in Arg group and Glu group too(P<0.05).【Conclusion】 Compare with routine PN,the immune response and stress status of patients after esophageal cancer surgery can Glu or(and) Arg enhancing PN.Among which the jointly using Glu and Arg is stronger than the using Arg or Glu alone.更多还原