摘要
目的探讨谷氨酰胺对胃癌患者术后化疗的影响。方法将72例胃癌术后化疗患者随机分为试验组和对照组。试验组患者化疗期间外周静脉滴注丙氨酸-谷氨酰胺(0.3g/kg),对照组予以静脉滴注同等剂量生理盐水,两组患者普通饮食。分别于化疗前1日和化疗结束后1日检测患者血浆谷氨酰胺水平;外周血单个核细胞(PBMC)中白介素1α(IL-1α)、IL-2、IL-6和肿瘤坏死因子α(TNF-α)mRNA表达水平;血清总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)、视黄醇结合蛋白(RBP)、转铁蛋白(TFN)水平;血浆免疫球蛋白、T细胞亚群以及D-乳酸水平;动态观察患者饮食及呕吐腹泻情况。结果化疗前两组各指标差异无显著性。化疗结束后试验组谷氨酰胺,ALB、RBP、PA、TFN,IgA和IgG,CD4+及CD4+/CD8+水平均显著高于对照组(P<0.05,P<0.01);化疗结束后两组IL-6和TNF-α的mRNA表达均显著升高,试验组IL-1α、TNF-α和IL-6表达均显著低于对照组(P<0.05,P<0.01);试验组血浆D-乳酸水平显著低于对照组(P<0.05)。结论给予术后化疗胃癌患者谷氨酰胺营养支持,可提高结构蛋白质合成,改善营养水平,减少炎性介质表达,降低肠道通透性,改善肠黏膜屏障功能和免疫功能,有益于防治化疗并发症。
Objective To study the effects of glutamine on patients undergoing postoperative chemotherapy for gastric carcinoma. Methods Totally 72 patients were randomly divided into glutamine group （parenteral nutrition with alanine-glutamine [ Ala-Gln] ） ） and control group （standard diet）. The levels of glutamine in plasma, total protein （ TP）, albumin （ ALB）, retinol-binding protein （ RBP）, pre-al-bumin （ PA）, and transferring （TRF） were determined one day before and after chemotherapy. The D-lactate, immunoglobumin and T-lymphocyte subgroups; interleukin-1 α （ IL-1α）, interleukin-2 （ IL-2 ）, interleukin-6 （ IL-6 ）, tumor necrosis factor-α （TNF-α） in peripheral blood monocytes were measured by reversed transcription polymerase chain reaction （RT-PCR）. Symptoms oincluding vomitus, diarrhea and appetite were observed. Results Compared to the control group, the levels of glutamine, ALB, RBP, PA, TFN, TFN, IgG, CD4^＋ and CD^4 ＋/CD^8 ＋ in glutamine groups were significantly higher. The D-lactate in plasma and IL-1α, IL-6, and TNF-α mRNA in peripheral blood monocytes decreased significantly （ P 〈 0.05 ） ; Vomitus and diarrhea were significantly lower in glutamine group. Conclusions Glutamine supports for post-operative chemotherapy of the gastric carcinoma can decrease protein metabolism and pro-inflammatory cytokines, increase the synthesis of construction protein, improve nutrition status, improve organic immune function, and strengthen intestinal mucosal barrier. It prorides a new way to prevent and treat the chemotherapy complications.
出处
《中国临床营养杂志》
2006年第6期369-373,共5页
Chinese Journal of Clinical Nutrition
关键词
谷氨酰胺
胃癌
化疗
炎性介质
肠道黏膜屏障
蛋白质
glutamine
gastric cancer
chemotherapy
pro-inflammatory cytokines
intestinal mucosal barrier
protein
