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目的:研究谷氨酰胺(Gln)和精氨酸(Arg)配合放疗对肺癌病人营养状况的影响和机体免疫功能的变化。方法:收集临床确诊为非小细胞肺癌病人36例,随机分为单独放疗组(n=18例)和联合治疗组(n=18例)。单独放疗组病人行单独放疗,联合治疗组病人在放疗同时的第1～10天,静脉给予Gln和Arg。所有病人在放疗期间饮食由医院营养师统一制订,保证热量供给基本相同。所有病人分别于放疗前、中、后抽取静脉血,检测血清清蛋白、前清蛋白、淋巴细胞计数、C反应蛋白、补体C3、IgG和CD3+、CD4+、CD8+和CD4+/CD8+。结果:联合治疗组病人放疗中和放疗结束时血清前清蛋白较单独放疗组升高,且有显著性差异(P<0.05),C反应蛋白和补体C3放疗中较放疗前降低。联合治疗组CD3+、CD4+放疗中较放疗前上升,CD8+下降,与单独放疗组比,放疗中、放疗后CD4+/CD8+升高明显,并且有显著性差异(P<0.01)。结论:Gln和Arg配合放疗可以提高肺癌病人CD4+/CD8+水平,增强细胞免疫功能;同时阻止机体蛋白质降解速度,提高放疗中的营养状况。
Objective: To investigate the effects of glutamine (Gln) and arginine (Arg) combined with radiotherapy on the nutritional status of lung cancer patients and the changes of immune function. Methods: Thirty-six patients with clinically diagnosed non-small cell lung cancer were randomly divided into radiotherapy group (n = 18) and combination therapy group (n = 18). Patients in the radiotherapy alone group were given radiotherapy alone. Gln and Arg were intravenously administered to the patients in the combination therapy group from the first to the tenth day of radiotherapy. All patients during the radiotherapy diet by the hospital dietitian unified development, to ensure the same caloric supply. Venous blood was collected before, during and after radiotherapy. Serum albumin, prealbumin, lymphocyte count, C - reactive protein, complement C3, IgG and CD3 +, CD4 +, CD8 + and CD4 + / CD8 + were detected in all the patients. Results: Serum prealbumin was significantly increased at the end of radiotherapy and radiotherapy in combination therapy group compared with radiotherapy group (P <0.05). C-reactive protein and complement C3 radiotherapy were lower than before radiotherapy. CD3 +, CD4 + radiotherapy in combination therapy increased compared with that before radiotherapy, and CD8 + decreased. Compared with radiotherapy, CD4 + / CD8 + increased significantly after radiotherapy, and there was a significant difference (P <0.01). Conclusion: Gln and Arg combined with radiotherapy can improve the level of CD4 + / CD8 + in lung cancer patients and enhance cellular immune function. At the same time, it can prevent the speed of protein degradation and improve the nutritional status in radiotherapy.