胃癌手术后早期肠内营养对T淋巴细胞亚群的影响

目的 探讨胃癌病人手术后早期肠内营养对T淋巴细胞免疫功能的影响。方法 30例胃癌根治术病人随机分成3组：对照组、肠外营养组（TPN组）、肠内营养组（TEN组），分别给予普通静脉输液、全肠外营养及全肠内营养8d。术前、术后第1、3、6、9天以碱性磷酸酶－抗碱性磷酸酶（APAAP）法测定T淋巴细胞亚群（CD3、CD4、CD8）变化。结果 对照组和TPN组术后CD3、CD4阳性细胞数及CD4／CD8比值明显降低，CD8阳性细胞数明显升高。TNE组术后第1天CD3、CD4阳性细胞数及CD4／CD8比值明显降低，但自术后第3天起即开始上升，并逐渐恢复至术前水平。术后第3、6、9天CD3、CD4阳性细胞数及CD4／CD8比值明显高于对照组和TPN组（P＜0.05)，而CD8阳性细胞数明显低于对照组和TPN（P＜0.05)，术后第9天时CD4／CD8比值明显高于术前水平。结论 早期肠内营养可纠正胃癌手术后病人的T淋巴细胞免疫抑制状态，促进T淋巴细胞免疫功能的恢复。

The effects of early enteral nutrition on T-lymphocyte subsets in patients with gastric carcinoma after operations

Objective: To study the effect of early enteral nutrition on T-lymphocyte subsets in patients with gastric carcinoma after operations. Methods: 30 patients with gastric carcinoma were divided into three groups after radical resections: control group, TPN group,and TEN group. The changes of T-lymphocyte subsets were determined by A-PAAP mehtod at postoperative 0,1,3,6,9 days. Results: The number of CD3 and CD4 positive cell and CD4/CD8 rate decreased significantly,and CD8 cell number increased markedly in control group and TPN group after operations. In TEN group, the number of CD3 and CD4 positive cell and CD4/CD8 rate decreased at the lst day after operation,but then recovered gradually from the 3th day after operation. The number of CD3 and CD4 positivecell and CD4/CD8 rate in TEN group were higher than those of in central group and TPN group at the 3th,6th,9th days after operations(P<0.05). Conclusion: Early enteral nutrition can enhance T-lymphocyte immune function and improve lymphocytic immunosup-pression after operations in patients with gastric carcinoma.