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目的探讨精氨酸(Arg)强化肠内营养对消化道肿瘤术后患者免疫功能及炎性反应的影响。方法将消化道肿瘤患者96例双盲、随机分为研究组和对照组。手术后第2天开始给予等热量、等氮量肠内营养制剂1周。研究组使用含Arg强化的肠内营养剂Impact,对照组使用普通的肠内营养剂Nutrison。对比观察术前、术后第1天和第8天两组血浆蛋白质水平、氮平衡、免疫功能状况、炎性反应、感染有关并发症、住院时间。结果在进行7 d的肠内营养以后,两组患者生命体征、血常规、肝肾功能、蛋白质水平、氮平衡、血脂和全身副反应差异无统计学意义;两组患者术后均有急性炎性反应的发生和免疫功能的降低。术后第8天研究组较对照组的IgG、IgA、IgM和CD3、CD4明显升高(P>0.05);血清IL-6、TNF-α、CRP、PGE2显著下降。术后住院时间,研究组显著低于对照组(P<0.05)。结论消化道肿瘤术后添加Arg的肠内营养,能改善患者手术后免疫功能低下,缓解急性炎性反应。
Objective To investigate the effect of arginine (Arg) enteral nutrition on immune function and inflammatory response in patients with gastrointestinal cancer. Methods 96 cases of patients with gastrointestinal cancer were double-blind, were randomly divided into study group and control group. On the second day after surgery, equal calorie and equal nitrogen enteral nutrition preparations were given for one week. The study group used an enteral supplement containing Arg Impact, while the control group used the common enteral nutrient Nutrison. The levels of plasma protein, nitrogen balance, immune function, inflammatory response, complications related to infection and hospital stay were observed before and 1 and 8 days after operation. Results After enteral nutrition for 7 days, there was no significant difference in vital signs, blood routine, liver and kidney function, protein level, nitrogen balance, blood lipid and systemic side effects between the two groups. Both groups had acute inflammation The occurrence of sexual reactions and immune function decreased. The levels of IgG, IgA, IgM, CD3 and CD4 in the study group were significantly higher than those in the control group on the 8th postoperative day (P> 0.05). The levels of IL-6, TNF-α, CRP and PGE2 in the study group decreased significantly. After hospital stay, the study group was significantly lower than the control group (P <0.05). Conclusions The addition of Arg enteral nutrition after digestive tract tumor surgery can improve the immunocompromised patients after operation and relieve the acute inflammatory reaction.