摘要
目的研究肠外肠内营养支持对进展期胃癌新辅助化疗患者营养状况、功能状态和T细胞亚群的影响。方法营养支持组28例进展期胃癌新辅助化疗患者,新辅助化疗后给予PN、EN或联合营养支持。对照组25例进展期胃癌,行新辅助化疗,自然进食。检测分析两组血清总蛋白、白蛋白、前白蛋白,CD4^+、CD8^+细胞百分比及CD4^+/CD8^+比值。结果营养支持组新辅助化疗前后血清总蛋白、白蛋白、前白蛋白水平无统计学差异(P>0.05)。对照组新辅助化疗后总蛋白和前白蛋白水平较化疗前降低,差异有统计学意义(P<0.01)。营养支持组Karnofsky评分和Zubrod-ECOG-WHO分级高于对照组。对比两组术前1d和术后5dT细胞亚群变化,营养支持组CD4^+细胞百分比和CD4^+/CD8^+比值均高于对照组。结论营养支持对改善进展期胃癌新辅助化疗患者营养和功能状态,提高患者细胞免疫功能,保证围术期安全有重要意义。
Objective To investigate the effect nutrition support on the nutritional improvement and T cell subpopulation immunity in patients with gastric cancer for neoadjuvant chemotherapy. Methods Twenty - eight patients with advancing gastric cancer were assigned to the group of nutrition support with PN and EN, and 25 another patients were in a control group of natural food intake. Neoadjuvant chemotherapy was administered in all the patients. Total serum protein （ TSP）, albmnin （ ALB ）, and prealbumin （ PA ） were assayed. T cell subpopulation of CD4＋ and CD8＋ cells, and the ratio of CD4＋ to CD8＋ were also studied. Results The serum levels of TSP, ALB, and PA were not significantly different before and after neoadjuvant chemotherapy in the nutrition support group（P 〉0.05）, but decreased in the control group after neoadjuvant chemotherapy（P 〈0.01 ）. The functional status of patients in the nutrition support group was better than that in control group. By comparison of T cell subpopulation changes at one day before and at five day after operation of radical gastrectomy with D2 lymphadenectomy, the percentage of CD4＋ cells and the ratio of CD4＋ to CD8＋ were normal in the nutrition support group, but lower in the control group. Conclusions Nutritional support is important for improving nutritional status, immunity, and perioperative safety in patients with gastric cancer for neoadjuvant chemotherapy.
出处
《武警医学》
CAS
2010年第3期192-194,共3页
Medical Journal of the Chinese People's Armed Police Force
基金
国家自然科学基金(30471700)
关键词
营养支持
胃癌
新辅助化疗
nutrition support
gastric neoplasm
neoadjuvant chemotherapy
