精氨酸联合谷氨酰胺的肠外营养对胃癌术后病人的作用

目的:评价应用精氨酸(Arg)联合谷氨酰胺(Gln)的肠外营养(PN)对胃癌病人术后营养状况、免疫功能和应激状态的影响.方法:将80例胃癌病人随机分为Arg组、Gln组、Arg Gln组及常规PN组(Rou组),每组20例.术后给予添加不同免疫营养素的PN 1周,观察各组的营养状况、免疫功能和应激状态的变化.结果:术后第8天时,Arg组、Gln组和Arg Gln组均比Rou组更能维持胃癌术后病人的营养状态,差异均有显著性意义(P＜0.05);Arg组、Gln组和Arg Gln组均比Rou组更能改善胃癌病人术后的免疫功能,差异均有显著性意义(P＜0.05),其中Arg Gln组与Rou组相比,差异有极显著性意义(P＜0.01);Arg组、Gln组和Arg Gln组与Rou组比更能抑制胃癌病人术后的应激反应,差异均有显著性意义(P＜0.05),其中C反应蛋白Arg Gln组比Rou组差异有极显著性意义(P＜0.01).结论:Arg联合Gln的PN比单用Arg或Gln的PN对增强胃癌根治术后病人细胞免疫功能、抑制其应激反应更为明显.

Effect of postoperative parenteral nutrition with arginine and glutamine on patients with gastric cancer

Objective:To evaluate the effect of Arg and Gln enriched PN on nutrition status,immune function and stress status of gastric cancer patients after radical treatment.Methods:Eighty patients with gastric cancer were randomly divided into 4 groups: arg group(arginine enriched PN group),Gln group(glntamine supplemented PN group),Arg Gln group(arginine and glutamine enriched PN group)and Rou group(Routine PN group).The distinct immune nutrients were added into PN in the different groups for 7 consecutive days.The difference of the patients' nutrition status,immune function and stress status were analyzed after operation.Results: The nutritional station and immunue fuction in Arg group,Gln group and Arg Gln group were better than in Rou group on the 8th postoperative day.The concentration of CRP in the Arg Gln group was different from that in other groups(P<0.01).Conclusion: The usage of PN with arginine and glntamine is more effective in enhancing the cellular immunue fuction and suppressing the inflammatory reaction in gastric cancer patients.