肺癌术后营养支持对免疫功能的影响

目的：观察早期营养支持对肺癌患者术后免疫功能恢复的影响。方法：回顾分析本科手术治疗且病历资料完整的肺癌患者65例,根据有无给予早期营养支持分为观察组35例、对照组30例,观察组于术后第1天即给予静脉营养支持治疗,每日提供非蛋白热卡20Kcal/kg·d-1,氮0.29/Kg·d-1,共治疗5d;对照组于术后第2天,给予患者流质饮食,每日静脉摄入〈200Kcal非蛋白热卡,同时输注少量葡萄糖溶液及生理盐水。观察两组术前、术后1、7d血T细胞亚群、营养状况变化。结果：两组术后第1天CD3＋,CD4＋CD4＋/CD8＋比值均下降,差异具有统计学意义（P〈0.05）,但两组间比较,差异无统计学意义（P〉0.05）;观察组术后第7天转铁蛋白（TFN）、前白蛋白（PA）、CD3＋、CD4＋CD4＋/CD8＋比值升高,CD8＋细胞下降,差异具有统计学意义（P〈0.05）;对照组术后第7天TFN、CD3＋、CD4＋、CD8＋、NK、CD9＋细胞下降,PA升高;术后第7天观察组各项指标均明显高于对照组,差异有统计学意义（P〈0.05）。结论：肺癌患者术后给予早期营养支持治疗,可有效改善患者营养状况,促进机体免疫功能恢复,缩短细胞免疫功能恢复的时间。

Effect of postoperative lung cancer nutrition support on immune function

Objective： To observe the effect of early nutrition support on the recovery of immune function for the post- operative lung cancer patients. Methods; A total of 65 lung cancer patients who underwent surgery were enrolled in the study and were divided into the observation group （35 cases） and the control group （30 cases）. The patients in the observation group were given intravenous nutrition support the first day after surgery, that is, they were provided with non-protein calorie 20Kcal/kg· d-1 , and nitrogen 0.29/Kg d-1 every day for five days. The patients in the control group were given liquid diet the second day after surgery and transfused less than 200Kcal non-protein calorie, simultaneously a little glucose solution and normal saline intravenously every day. The changes of blood T cell subset and nutritional status of the patients in the two groups before operation, the first day and the seventh day after surgery were observed. Results： Both of the CD3＋ , CD4＋, CD4＋/CD8＋ ratio in the two groups the first day after surgery were decreased （P〈0.05）, and the difference was not statisti- cally significant （P〉0.05）. The transferrin （TFN）, prealbumin （PA）, CD3＋ ,CD4＋ , CD4＋/CD8＋ ratio in the observation group the seventh day after surgery were elevated, and the number of CD8＋ was reduced （P〈0.05） ; however, the TFN, CD3＋ ,CD4＋ ,CD8＋ , NK,CD9＋ in the control group the seventh day after surgery were declined, and the PA was increased. The various indicators in the observation group the seventh day after surgery were significantly higher than those in the control group, and there was a significant difference between the groups （P〈0.05）. Conclusicns： Early nutrition support for the post-operative lung cancer patients can effectively improve the patients＇ nutritional status, promote the recovery of body immune function and shorten the recover time of ceUuar immune function.