【摘要】 目的:评价谷氨酰胺(Gln)强化的肠外营养(PN)支持对食管癌根治术后病人应激反应及免疫功能的影响。方法:选取食管癌根治术后的病人72例,随机双盲分为试验组(Gln强化组)和对照组(单纯PN组),每组36例。术后分别给予两组病人等氮和等热量营养支持7 d,试验组病人术后24 h内于PN液中添加Gln为0.35 g/(kg·d)。比较两组病人手术前后免疫和炎性指标变化。结果:两组病人术前C3、C4和C反应蛋白(CRP)均高于正常值,IgA、IgG、IgM均低于正常值,CD3、CD4、CD4/CD8均低于正常值,CD8高于正常值。术后第1天,两组病人C3、C4和CRP均进一步升高,IgA、IgG、IgM均较术前有所下降,CD3、CD4、CD4/CD8均较术前下降。术后第7天,试验组病人CRP显著低于对照组(P<0.05),而IgA、IgG显著高于对照组(P<0.05),CD4亦显著高于对照组(P<0.05)。结论:添加Gln强化的PN支持能有效地改善食管癌病人术后的免疫功能和减轻应激反应。更多还原

【Abstract】 Objective: To determine the effects of glutamine enriched PN on nutrition status,immune function and stringent status following esophageal cancer surgery. Methods: 72 esophageal cancer patients who underwent the same elective operation were randomized into 2 groups. Both groups were treated with equal calorie and equal nitrogen by central vein during 7 days after operation. Gln enriched PN group were given Gln 0. 35 g /(kg·d) for seven days. The status of immunological parameters and inflammatory parameters were observed and analyzed. Results: Before the operation,the levels of IgA,IgG,IgM,CD3,CD4 and CD4 /CD8 of the two groups were less than those of the low limit of normal value. The status of C3,C4 and CRP of the two groups were more than those of the up limit of normal value. On the seventh day,the status of CRP of Gln group were less than that of the routine group(P <0.05),while the status of IgA,IgG and CD4 of Gln group were more than those of the routine group(P <0.05). Conclusion: Compared with PN group,the immune response and stress status of patients after esophageal cancer surgery can be ameliorated by Gln enhancing PN.更多还原