【摘要】 目的研究谷氨酰胺肠内营养在局部晚期胃癌治疗中的应用。方法选取84例晚期胃癌患者,按照随机数字表法均分为观察组和对照组。2组均给予百普素进行肠内营养治疗,对照组采用奥沙利铂-卡倍他滨(XELOX)方案完成化疗,观察组在对照组化疗的基础上增加谷氨酰胺。比较2组患者的血管内皮生长因子(VEGF)表达、尿乳果糖/甘露醇比值(L/M)、血浆谷氨酰胺浓度、血浆二胺氧化酶(DAO)水平以及不良反应。结果治疗前,2组患者的VEGFR-1、VEGF-D和VEGF-A水平比较差异均无统计学意义,治疗后,观察组的VEGFR-1和VEGF-A水平显著低于对照组(P<0.05),VEGF-D水平显著高于对照组(P<0.05)。治疗前,2组患者的尿L/M比值、血浆谷氨酰胺浓度、血浆DAO水平比较差异均无统计学意义,治疗后,观察组的血浆谷氨酰胺浓度显著高于对照组(P<0.05),尿L/M比值、血浆DAO水平显著低于对照组(P<0.05)。2组患者粒细胞、血小板和白细胞数量均减少、神经毒性比较差异均无统计学意义,观察组的胃肠道反应率显著低于对照组(P<0.05)。结论谷氨酰胺肠内营养在XELOL方案治疗局部晚期胃癌患者中,能抑制VEGF表达,保护肠屏障功能,降低胃肠道反应。更多还原

【Abstract】 Objective To investigate the application of glutamine enteral nutrition in the treatment of locally advanced gastric cancer.Methods 84 patients with advanced gastric cancer were randomly divided into observation group and control group.Both groups were given pupupus for enteral nutrition treatment,the control group was treated with oxaliplatin-capecitabine(XELOX) chemotherapy,and the observation group was given glutamine on the basis of the control group.The vascular endothelial growth factor(VEGF) expression,lactulose/mannitol ratio(L/M),plasma glutamine concentration,plasma diamine oxidase(DAO) level and adverse reactions were compared between the 2 groups.Results Before treatment,the levels of VEGFR-1,VEGF-D and VEGF-A in the 2 groups had no significant difference.After treatment,the levels of VEGFR-1 and VEGF-A in the observation group were significantly lower than those in the control group(P<0.05),VEGF-D levels were significantly higher than those of the control group(P<0.05).Before treatment,there was no significant difference in urine L/M ratio,plasma glutamine concentration and plasma DAO level between the 2 groups.After treatment,the plasma glutamine concentration in the observation group was significantly higher than that in the control group(P<0.05),urine L/M ratio and plasma DAO level were significantly lower than those in the control group(P<0.05).There was no significant difference in neutropenia,thrombocytopenia,neutropenia and neurotoxicity between the 2 groups.The gastrointestinal reaction rate in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Glutamine enteral nutrition in the treatment of patients with locally advanced gastric cancer under XELOX regimen can inhibit VEGF expression,protect intestinal barrier function and reduce gastrointestinal reaction.更多还原