谷氨酰胺对老年胃肠道肿瘤患者术后蛋白质代谢及免疫功能的作用

目的:探讨谷氨酰胺对老年胃肠道肿瘤患者术后蛋白质代谢及免疫功能的影响。方法:选取2007-03/2010-03胃肠道肿瘤患者87例,术后2 h开始给予肠外营养,同时加入谷氨酰胺0.6 g/(Kg.d),持续8 d。采用单向免疫扩散法测定血清IgA、IgG、IgM,采用免疫组化法测定外周血CD3+、CD4+、CD8+、CD4+/CD8+,同时测定蛋白质代谢的指标(包括氮平衡、血浆白蛋白、前白蛋白、转铁蛋白)。结果:老年胃肠道肿瘤经治疗后CD3+、CD4+、CD8+、CD4+/CD8+、IgG、IgA、IgM显著升高,与治疗前比较差异有统计学意义(P<0.05);术后第4天Alb、PAB、TF显著下降(P<0.05),术后第8天得到较为明显的恢复(P<0.05);肿瘤患者负氮平衡状态术后早期加重,经谷氨酰胺治疗8 d后恢复至术前水平(P<0.05),差异有统计学意义。结论:谷氨酰胺可显著改善老年胃肠道肿瘤患者术后营养,提高患者的免疫功能。

The effect of protein metabolism and immunologic function of glutamine after operation in elder gastrointestinal tumor

AIM: To explore the effect of protein metabolism and immunologic function of glutamine after operation in elder gastrointestinal tumor.METHODS: Form march 2007 to 2010,87 csaes of elder gastrointestinal tumor were given parenteral nutrition and glutamine 0.6 g/(Kg·d).The period of treatment were 8 days.IgA,IgG,IgM were measured by single immunodiffusion,CD3+,CD4+,CD8+,CD4+/CD8+ were measured by immunohistochemical method,and the index(Alb,PAB,TF,nitrogen equilibrium) were monitored the proteid catabolism distribution.RESULTS: After the treatment,CD3+,CD4+,CD8+,CD4+/CD8+、 IgG,IgA,IgM were evidently declined(P<0.05).Alb,PAB,TF were evidently declined in 4 days postoperatively(P<0.05),the restore were more obvious in 8 days postoperatively(P<0.05).Nitrogen equilibrium was worse in the early postoperative and the restore were more obvious in 8 days postoperatively(P<0.05).CONCLUSION: Glutamine can improve patient’s nutrition,enhance their immunologic function.