肠内营养对食管癌病人术后免疫功能的影响

目的研究肠内营养(EN)对食管癌病人术后免疫功能的影响。方法60例食管癌手术病人,随机分为肠外营养(PN)组和EN组,各30例。手术后第1天开始等热、等氮量(125 kJ.kg-1.d-1)营养支持。手术前1 d、术后1 d和9 d分别取外周血检测B淋巴细胞,IgA,IgG,IgM,淋巴细胞总数,CD3,CD4,CD4/CD8,NK,CD8细胞活性等免疫指标。结果术后9 d两组B淋巴细胞数均无明显改变,EN组IgA、IgG、IgM、淋巴细胞总数、CD3、CD4、及CD4/CD8及NK细胞活性明显回升,CD8则回落正常水平,而PN组CD8仍处高水平,其余指标仍处于低水平,两组间差别有统计学意义(P<0.05)。结论EN可增强食管癌病人术后免疫功能。

Effect of Enteral Nutrition on Immune Function after Esophagectomy of Esophaged Carcinama

Objective To study the effect of enteral nutrition on immune function of patients after esophagectomy.Methods Sixty patients who underwent surgery for esophageal cancer were randomized into parenteral nutrition(PN) group(n=30) or enteral nutrition(EN) group(n=30).From the 1st day after operation,the patients received either parenteral nutrition or enteral nutrition,with an isocaloric and isonitrogenous for one week.Host immunity was evaluated by IgA,IgG,IgM,total lymphocytes,B-lymphocytes,CD_3,CD_4,CD_8,CD_4/CD_8,NK cell activity on preoperative 1 day,postoperative 1 day and 9 day.Results\ 60 cases completed the study.On postoperative 9 day,there was no significant difference in B-lymphocytes,but the levels of IgA,IgG,IgM,CD_3,CD_4,CD_4/CD_8,total lymphocytes were significantly higher and CD_8 was significantly lower in the study group than in the control group.Conclusion Compared with the parenteral nutrition,enteral nutrition can improve obviously the immunity function in patients undergoing surgery for esophageal cancer.