谷氨酰胺、精氨酸强化的全胃肠外营养对结直肠癌术后患者免疫功能的影响

 目的 探讨应用谷氨酰胺、精氨酸强化的TPN对结直肠癌术后患者免疫功能的影响。方法 按照手术方式配对将2005年8月～2006年8月间结直肠癌病例分为实验组和对照组，每组各24例。自术后第1天至术后第7天，实验组应用谷氨酰胺（Gln）、精氨酸（Arg）强化的TPN，对照组应用常规TPN，所有病例均于术前及术后第4天、第8天检测体液免疫指标（IgA、IgG、IgM）和细胞免疫指标（CDL3、CI）4、CD8、CD4／CD8）。结果 与术前比较，两组体液免疫及细胞免疫指标术后第4天降低，术后第8天均有所恢复。实验组术后第8天IgA、IgG、CD3、CD4、CD4／CD8值均升高，与对照组比较，差异有统计学意义（P〈0．05）。结论 谷氨酰胺和精氨酸强化的TPN能有效促进结直肠癌患者术后免疫功能的恢复。

Effects of Total Parenteral Nutrition Supplemented with Glutamine and Arginine on Postoperative Immune Function in Patients with Colorectal Cancer

Objective 　To study the effect of total parenteral nut rition ( TPN) supplemented with glutamine and arginine on the postoperative immune function of the patient s with colorectal cancer. Methods 　According to the operative methods with match ,the patient s with colorectal cancer between August 2005 and August 2006 were divided into experiment group and control group ,including 24 cases respectively. From the first day to the seventh day af ter operation ,TPN supplemented with glutamine and arginine was used in the experiment group ,while standard TPN was used in the control group. The humoral immune markers ( IgA , IgG, IgM) and cellular immune markers (CD3 ,CD4 ,CD8 ,CD4/ CD8) were measured in all cases before the operation ,on the fourth day and the eighth day af ter operation. Results 　Compared with the preoperative immunity ,the levels of humoral and cellular immunity declined on the fourth day , but they resumed on the eighth day after operation. Compared with the cont rol group , IgA、IgG、CD3 、CD4 、CD4/CD8 in the experiment group on the eighth day af ter operation increased significantly ( P < 0. 05) . Conclusion 　TPN supplemented with glutamine and arginine can improve the immune function of patient s with colorectal cancer after operation effectively.