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目的:探讨谷氨酰胺(Gln)和精氨酸(Arg)对围手术期结直肠肿瘤病人免疫功能和营养状况的影响。方法:将62例结直肠肿瘤病人随机分为对照组和研究组,每组31例。对照组病人行肠外营养(PN),研究组行PN加Gln和Arg,观察结直肠肿瘤病人术前3 d、术后第2和第7天免疫反应和营养状态的变化。结果:术后第7天,研究组病人血清免疫球蛋白A水平、CD4/CD8比值和体重指数(BMI)明显高于对照组和术前3 d,而血液C-反应蛋白和肿瘤坏死因子-α水平明显低于对照组和术前3 d。血清总蛋白、清蛋白、前清蛋白、白细胞介素-2(IL-2)、CD4、CD8、IgG、IgM水平变化无显著性差异。结论:Gln和Arg可提高围手术期结直肠肿瘤病人机体免疫应答,减轻炎性反应,调节肿瘤病人的代谢异常。
Objective: To investigate the effects of glutamine (Gln) and arginine (Arg) on immune function and nutritional status in patients with colorectal cancer during perioperative period. Methods: 62 cases of colorectal cancer patients were randomly divided into control group and study group, 31 cases in each group. Patients in the control group underwent parenteral nutrition (PN). Patients in the study group received PN plus Gln and Arg. The immune response and nutritional status of the patients with colorectal cancer were observed 3 days before operation and 2 and 7 days after operation. Results: Serum immunoglobulin A level, CD4 / CD8 ratio and body mass index (BMI) in study group were significantly higher than those in control group and preoperative 3 days after operation on the 7th day. The levels of serum C - reactive protein and tumor necrosis factor - α levels were significantly lower than the control group and 3 d before surgery. Serum total protein, albumin, prealbumin, interleukin-2 (IL-2), CD4, CD8, IgG, IgM levels did not change significantly. Conclusion: Gln and Arg can improve the immune response of the patients with colorectal cancer during perioperative period, reduce the inflammatory reaction and regulate the metabolic abnormalities in cancer patients.