Clinical application of immune-enhanced enteral nutrition in patients with advanced gastric cancer after total gastrectomy
Clinical application of immune-enhanced enteral nutrition in patients with advanced gastric cancer after total gastrectomy
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DOI：
10.1111/j.1751-2980.2012.00596.x
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发表时间：
2012-08-01
影响因子：
3.5
通讯作者：
Cao, Hui
中科院分区：
文献类型：
--
作者：
Liu, Hua;Ling, Wei;Cao, Hui
目的：目的探讨免疫增强型肠内营养（EN）对进展期胃癌（AGC）患者全胃切除术后的营养状况、免疫功能、手术疗效及住院天数的影响。方法：2005年8月至2011年5月，78例行全胃切除术的AGC患者随机分为3组：免疫增强EN（EN + Gln）组、标准EN组和对照组。分别于术前第1天、术后第2天和第12天检测血清总蛋白、白蛋白、前白蛋白和转铁蛋白。还比较了免疫球蛋白M（IgM）、免疫球蛋白G（IgG）、自然杀伤（NK）细胞、CD4+和CD8+ T细胞的水平。结果：除5例患者出现轻度并发症外，其余患者均耐受良好。EN + Gln组和EN组的肛门排气时间和住院时间均短于对照组。术后第12天，EN + Gln组和EN组的血清总蛋白、白蛋白、前白蛋白和转铁蛋白水平均显著高于对照组（P < 0.05）。EN + Gln组术后CD4+ T细胞、NK细胞、IgM和IgG水平明显升高，与术前、EN组和对照组相比差异有统计学意义。结论：免疫增强EN能改善AGC患者全胃切除术后的营养状况和免疫功能。
OBJECTIVE: To determine whether immune-enhanced enteral nutrition (EN) was effective on nutritional status, immune function, surgical outcomes and days of hospitalization after total gastrectomy for patients with advanced gastric cancer (AGC). METHODS: From August 2005 to May 2011, 78 patients with AGC who underwent a total gastrectomy were enrolled and divided randomly into three groups: immune-enhanced EN (EN + glutamine [Gln]) group, standard EN group and control group. Serum parameters including total protein, albumin, proalbumin and transferrin were examined on preoperative day 1, postoperative day 2 and day 12. Levels of immunoglobulin M (IgM), immunoglobulin G (IgG), natural killer (NK) cells, CD4+ and CD8+ T cells were also compared. RESULTS: The formulas were tolerated well in all the patients except 5 with mild complications. The EN + Gln and EN groups showed a faster onset of flatus and shorter hospitalization duration than the control group. On postoperative day 12, serum total protein, albumin, proalbumin and transferrin levels of the EN + Gln and EN groups were significantly higher than those of the control group (P < 0.05). CD4+ T cells, NK cells, IgM and IgG levels of the EN + Gln group increased prominently, and were significantly higher than those before the operation as well as those in the EN and control groups. CONCLUSION: Immune-enhanced EN can improve nutritional status and immune function for the patients with AGC after total gastrectomy.