不同剂量精氨酸强化的肠外营养对胃肠癌患者术后免疫功能的影响

目的:探讨不同剂量精氨酸(Arg)强化的肠外营养(TPN)对胃肠癌患者术后免疫功能的影响.方法:选择90例胃肠癌患者,术后分别给予肠外营养支持,随机分为对照组(常规TPN,30例),试验Ⅰ组(TPN+Arg 15 g,30例)和试验Ⅱ组(TPN+Arg 30g,30例),分析术前术后不同时期白蛋白、总蛋白、C3、C4、CD4+ 、CD8+、CD4+/CD8+等免疫功能指标变化.结果:与对照组相比,Arg强化的TPN试验组患者免疫功能在术后第4天均有明显改善(P<0.05),随着精氨酸剂量的增加,总蛋白、CD4+ 、CD8+、CD4+/CD8+等指标改善更为显著(P<0.01).结论:精氨酸强化的TPN能提高胃肠癌患者术后免疫功能,添加精氨酸30 g优于15 g.

Effects of Arginine enriched Parenteral Nutrition on Postoperative Immune Function in Patients with Gastrointestinal Tumors

Objective: To evaluate the effects of arginine-enriched TPN on postoperative immune function in the patients with gastrointestinal tumors.Method: 90 cases with gastrointestinal tumor operation were randomly divided into three groups: 30 cases in the control group with routine TPN,30 cases in the test-Ⅰgroup with TPN +15g arginine and 30 cases in the test-Ⅱgroup with TPN+30 g arginine.The immune function(ALB and TB,C3,C4,CD4+,CD8+ and CD4+/CD8+) was detected preoperatively and postoperatively at different time points.Result: The immune function was improved in the arginine-enriched groups as compared with that in the control group on the 4th day after the operation(P<0.05).With the amount increase of arginine,the immune function was enhanced significantly.Conclusion: Arginine-enriched TPN can improve the immune function in the patients with gastrointestinal tumors,and 30 g L-arginine is better than 15 g one.