早期肠内营养对老年胃癌病人术后血清SOD、MDA和T细胞免疫功能的影响

目的:探讨早期肠内营养(EEN)对老年胃癌病人术后机体外周血中超氧化物歧化酶(SOD)、丙二醛(MDA)的变化以及T细胞免疫功能的影响。方法:选择老年胃癌手术病人45例,随机分为两组,EEN组26例,于术后第1天起给予EN治疗,共实施7 d,总量递增;肠外营养(PN)组19例,术后第1天开始给予PN治疗。两组病人分别于手术前、术后第1和第7天检测血清SOD、MDA值和T细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+),并进行相关性分析。结果:两组病人术后第1天血清SOD值明显低于手术前,有显著性差异(P<0.05),术后第7天较术后第1天均明显增高(P<0.05)。EEN组病人术后第1天血清MDA值与术前比明显上升,有显著性差异(P<0.05);PN组血清MDA值术后第1和第7天均上升,组间比较有显著性差异(P<0.05),术后第7天两组间MDA值有显著性差异(P<0.05)。CD3+、CD4+、CD4+/CD8+比值术后较术前均有所下降,有显著性差异(P<0.05)。EEN组术后第7天CD3+、CD4+、CD8+、CD4+/CD8+比值与PN组比较差异有显著性意义(P<0.05)。病人血清MDA变化值与T细胞亚群中CD4+/CD8+呈负相关性(r=-0.774,P<0.05)。结论:EEN可能通过调节血清SOD、MDA的变化,使老年胃癌术后病人T细胞免疫功能增强。

Effect of postoperative enteral nutrition on SOD, MDA and T lymphocyte subsets of elder patients with gastric cancer

Objective: To evaluate the effect of early enteral nutrition on SOD,MDA and T lymphocyte subsets in surgical elder patients with gastric cancer.Methods: 45 elder patients with gastric cancer were randomly divided into early enteral nutrition(EEN)group and control group(PN).The patients in EEN group received enteral nutrition from postoperative day1 to postoperative day 7.The patients in PN group received total parental nutrition.SOD,MDA and CD3+,CD4+,CD8+,CD4+/CD8+ were detected on the day before the operation and the postoperative day1 and 7.Results: As compared with the day before the operation,on postoperative day 1,the levels of SOD,CD3+,CD4+ and CD4+/CD8+ were decreased in two groups(P<0.05).Then the change of MDA was not significant in EEN group and there was significant difference between two groups on postoperative day 7(P<0.05).Negative correlation was found between the MDA and CD4+/CD8+(r=-0.774,P<0.05).Conclusion: Early enteral nutrition can improve obviously cellular immunity function in gastric cancer surgical patients by regulating the changs of SOD and MDA.