【摘要】 目的 :探讨脂肪乳剂对食管癌术后应激反应和免疫功能的影响。　方法 :采用前瞻性随机对照设计 ,将 33例食管癌切除术病人随机分为两组 ,A组 (15例 )为对照组 ,接受不含脂肪乳剂的肠外营养 ,B组 (18例 )接受含有脂肪乳剂的肠外营养。两组病人的一般临床情况、营养热量分布一致。分别于术前、术后不同时段测定血清中皮质醇、IL 6和IL 10、T细胞亚群、NK细胞活性、免疫球蛋白和血清蛋白浓度。　结果 :术后第 1、3天两组病人血清皮质醇和IL 6水平均显著升高 (P <0 .0 1) ,且B组显著高于A组。术后两组CD3+ 、DC4 + 、CD4 + /CD8+ 均显著降低(P <0 .0 1)。术后 10天B组CD4 + /CD8+ 比值显著低于A组 (P <0 .0 5 )。术后 3天CD4 + /CD8+ 比值与血清皮质醇呈显著正相关 ,亦与术后第 1天IL 6水平呈显著正相关。然而 ,术后血清IgA、IgM、IgG水平无显著变化 ,两组间亦无显著差异。　结论 :含大剂量亚油酸的脂肪乳剂能提高机体的应激反应及应激诱导的免疫抑制。更多还原

【Abstract】 Objectives:The purpose of this study was to investigate the effects of soybean oil emulsion on stress response and immune function after surgery for esophageal cancer. Mehtods:Patients who underwent esophagectomy with thoracotomy were divided into two groups.Group A(15 patients) received fatfree parenteral nutrition(PN) as the control group.Group B(18 patients) were fed by PN with soybean oil emulsion.There was no significant difference between the two groups in regard to either clinical backgrounds,nutritional parameters, or proteins measured before and after the operation. Results:The serum levels of cortisol and IL6 were significantly higher on the first and third postoperative days(P<0.01).IL6 levels in group B,however,were significantly higher than that in group A.The serum concentration of IL10 was similar to that of the IL6.CD3+,CD4+,DC4+/CD8+ and NK cell activity significantly decreased postoperatively(P<0.01),and statistically significant differences were observed in CD4+/CD8+ between group A and group B(P<0.05).Suppression of cellular immunity was correlated significantly with serum cortisol and IL6 and was preceded by a rise in serum IL6.The IgA,IgG,and IgM levels,however,remained unchanged from their preoperative values throughout the study in both groups. Conclusions:Perioperative PN with soybean oil emulsion may increase the production of inflammatory cytokines and promote the immunosupression.更多还原