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目的观察ω-3多不饱和脂肪酸(ω-3polyunsaturated fatty acid,PUFA)联合谷氨酰胺(glutamine,Gln)对食管癌手术患者免疫功能及营养状况的影响。方法择期行食管癌根治术患者98例随机分为观察组50例和对照组48例,对照组术后给予标准营养支持治疗。观察组在对照组治疗基础上给予PUFA 1.5g/(kg·d),1次/d,静脉滴注;Gln 0.4g/(kg·d),1次/d,静脉滴注。分别于术前、术后第1天和第7天检测患者IgG、IgA、IgM、CD4+、CD8+,计算CD4+/CD8+,比较2组术前和术后第7天血红蛋白、血清白蛋白、前白蛋白水平,并比较2组术后感染发生率和术后住院时间。结果观察组术后感染发生率为26.0%、住院时间为(11.0±3.6)d,对照组感染发生率为47.9%、住院时间为,(12.8±4.2)d,2组比较差异有统计学意义(P<0.01);2组术后第1天IgG、IgA、IgM、CD4+、CD4+/CD8+较术前下降(P<0.05);术后第7天观察组免疫学指标与术前比较差异均无统计学意义(P>0.05),对照组仍低于术前(P<0.05),2组比较差异有统计学意义(P<0.05);2组术后第7天血红蛋白、血清白蛋白、前白蛋白均较术前降低(P<0.01),观察组血清前白蛋白、白蛋白水平高于对照组(P<0.05)。结论 PUFA与Gln联合应用可改善行食管癌根治术患者术后免疫功能和营养状况。
Objective To observe the effect of ω-3 polyunsaturated fatty acid (PUFA) combined with glutamine (Gln) on the immune function and nutritional status of esophageal cancer patients. Methods Elective 98 cases of esophageal cancer radical operation were randomly divided into observation group of 50 patients and control group of 48 patients in the control group were given standard nutritional support after treatment. The observation group was given PUFA 1.5g / (kg · d) once a day, intravenous infusion of Gln 0.4g / (kg · d), once a day, intravenously. The levels of IgG, IgA, IgM, CD4 +, CD8 + were measured preoperatively, on the first day and the seventh day after surgery respectively. The preoperative and postoperative hemoglobin, serum albumin, Protein levels, and compared the incidence of postoperative infection and postoperative hospital stay in two groups. Results The incidence of postoperative infection in the observation group was 26.0%, the length of hospital stay was (11.0 ± 3.6) days, the incidence of infection in the control group was 47.9% and the length of hospital stay was (12.8 ± 4.2) days. There was significant difference between the two groups (P <0.01). The levels of IgG, IgA, IgM, CD4 +, CD4 + / CD8 + on the first day after operation in the two groups were significantly lower than those before operation (P <0.05) (P <0.05), while the control group was still lower than preoperative (P <0.05), the difference between the two groups was statistically significant (P <0.05); the hemoglobin, serum albumin, Prealbumin was lower than preoperative (P <0.01). The levels of prealbumin and albumin in observation group were higher than those in control group (P <0.05). Conclusion The combination of PUFA and Gln can improve postoperative immune function and nutritional status of esophageal cancer patients undergoing radical operation.