摘要
目的比较肠内营养与肠外营养对消化道肿瘤患者术后免疫功能的影响。方法将40例消化道肿瘤患者随机分为肠内营养(EN)组和肠外营养(PN)组,每组20例,试验周期为7天。术后第2天开始予等热量、等氮量营养支持1周。检测术前和术后第8天患者外周血淋巴细胞计数、淋巴细胞亚群CD3、CD4、CD8、CD25(IL-2受体)和NK细胞等细胞免疫指标,以及IgG、IgM、IgA、补体C3、C4、CH50和CRP等体液免疫指标。结果两组患者均无严重感染性并发症发生。两组总淋巴细胞计数在术前与术后第8天均无显著性变化。EN组CD3、CD4、CRP和IgM水平明显升高;PN组NK细胞水平明显下降,而IgA水平明显升高。结论术后肠内营养安全且可行。肠内营养可改善T辅助细胞功能,并维持NK细胞的正常水平;而肠外营养可能抑制机体的细胞免疫功能。外科营养对于体液免疫影响不大。
Objective To evaluate the effects of enteral nutrition(EN)and parenteral nutrition(PN)on immune function of patients following surgery for tumors of digestive system.Methods Forty patients who underwent surgery for tumor of digestive system were randomized to PN group(n=20)or EN group(n=20)for7days.Isocaloric and isonitrogenous nutritional supports began at the second day after operation and were maintained for a week.Immune variables such as peripheral lymphocytes cou nts,subsets of lymphocytes(CD3,CD4,CD8,CD25),serum immunoglobulins(IgG,IgM,IgA),complement system(C3,C4,CH50)and C-reactive protein(CRP)were measured preoperatively and on8days after operation.Results No serious infectious complications occurred in both groups.The peripheral lymphocyte counts did not change significantly on postoperative day8in both groups.Levels of CD3,CD4,CRP,and IgM were higher than that before the treatment in EN group.In PN group,the level of NK cells was decreased but that of IgA was increased significantly.Conclu sions EN after surgery is safe and feasible.EN could improve T-helper cell function and preserve the normal level of NK cells.PN may inhibit cellular immunities.Surgical nutrition seems to have little influence on humoral immunities.
出处
《中国临床营养杂志》
2002年第1期10-13,共4页
Chinese Journal of Clinical Nutrition
