中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
27期
1-4
,共4页
吕清泉%孙坚%叶亚林%马汉军
呂清泉%孫堅%葉亞林%馬漢軍
려청천%손견%협아림%마한군
脂肪乳剂,静脉注射用%肿瘤%系统性炎症反应综合征%免疫功能
脂肪乳劑,靜脈註射用%腫瘤%繫統性炎癥反應綜閤徵%免疫功能
지방유제,정맥주사용%종류%계통성염증반응종합정%면역공능
Fat emulsions,intravenous%Neoplasms%Systemic inflammatory response syndrome%Immunologic function
目的 探讨结构脂肪乳对消化道肿瘤术后患者炎性细胞因子和免疫功能的影响.方法 选取2010年7月至2012年2月收治消化道肿瘤术后患者80例,按分层抽样法随机分为结构脂肪乳组(观察组)和物理混合的中/长链脂肪乳组(对照组),每组40例,于术后1 ～6d接受等氮、等热量的肠外营养.对比观察两组患者术后一般情况,分别于术前,术后1、7d检测血清炎性细胞因子和免疫功能指标.结果 在进行6d的肠外营养以后,两组患者生命体征、血常规、肝肾功能、血脂等均在正常范围,观察组术后感染相关并发症发生率[12.5％(5/40)]较对照组[25.0％(10/40)]低,术后住院时间[(12.9±0.7 d)]较对照组[(13.1±0.9)d]短,但差异无统计学意义(P＞0.05).两组术后1d血清白细胞介素(IL)-1、IL-2、IL-6及肿瘤坏死因子(TNF)-α浓度均有不同程度下降,随后逐渐回升,观察组术后7d血清IL-2、IL-6和TNF-α浓度[(987±203)、(277±107)、(197±98) ng/L]明显低于对照组[(1347±195)、(752±187)、(342±106) ng/L](P＜ 0.05);两组术后1d外周血IgG、IgA、IgM、CD3+、CD4+、CD8+水平均有不同程度下降,随后逐渐回升,观察组术后7d外周血IgG、CD3+、CD4+水平[(14.2±1.8) g/L、0.746±0.111、0.580±0.067]较对照组[(12.1±2.8) g/L、0.606±0.101、0.404±0.072]明显升高(P＜0.05).结论 结构脂肪乳能减轻消化道肿瘤术后患者免疫抑制,减轻炎性反应,调控炎性细胞因子的产生和释放,改善机体免疫功能.
目的 探討結構脂肪乳對消化道腫瘤術後患者炎性細胞因子和免疫功能的影響.方法 選取2010年7月至2012年2月收治消化道腫瘤術後患者80例,按分層抽樣法隨機分為結構脂肪乳組(觀察組)和物理混閤的中/長鏈脂肪乳組(對照組),每組40例,于術後1 ～6d接受等氮、等熱量的腸外營養.對比觀察兩組患者術後一般情況,分彆于術前,術後1、7d檢測血清炎性細胞因子和免疫功能指標.結果 在進行6d的腸外營養以後,兩組患者生命體徵、血常規、肝腎功能、血脂等均在正常範圍,觀察組術後感染相關併髮癥髮生率[12.5％(5/40)]較對照組[25.0％(10/40)]低,術後住院時間[(12.9±0.7 d)]較對照組[(13.1±0.9)d]短,但差異無統計學意義(P＞0.05).兩組術後1d血清白細胞介素(IL)-1、IL-2、IL-6及腫瘤壞死因子(TNF)-α濃度均有不同程度下降,隨後逐漸迴升,觀察組術後7d血清IL-2、IL-6和TNF-α濃度[(987±203)、(277±107)、(197±98) ng/L]明顯低于對照組[(1347±195)、(752±187)、(342±106) ng/L](P＜ 0.05);兩組術後1d外週血IgG、IgA、IgM、CD3+、CD4+、CD8+水平均有不同程度下降,隨後逐漸迴升,觀察組術後7d外週血IgG、CD3+、CD4+水平[(14.2±1.8) g/L、0.746±0.111、0.580±0.067]較對照組[(12.1±2.8) g/L、0.606±0.101、0.404±0.072]明顯升高(P＜0.05).結論 結構脂肪乳能減輕消化道腫瘤術後患者免疫抑製,減輕炎性反應,調控炎性細胞因子的產生和釋放,改善機體免疫功能.
목적 탐토결구지방유대소화도종류술후환자염성세포인자화면역공능적영향.방법 선취2010년7월지2012년2월수치소화도종류술후환자80례,안분층추양법수궤분위결구지방유조(관찰조)화물리혼합적중/장련지방유조(대조조),매조40례,우술후1 ～6d접수등담、등열량적장외영양.대비관찰량조환자술후일반정황,분별우술전,술후1、7d검측혈청염성세포인자화면역공능지표.결과 재진행6d적장외영양이후,량조환자생명체정、혈상규、간신공능、혈지등균재정상범위,관찰조술후감염상관병발증발생솔[12.5％(5/40)]교대조조[25.0％(10/40)]저,술후주원시간[(12.9±0.7 d)]교대조조[(13.1±0.9)d]단,단차이무통계학의의(P＞0.05).량조술후1d혈청백세포개소(IL)-1、IL-2、IL-6급종류배사인자(TNF)-α농도균유불동정도하강,수후축점회승,관찰조술후7d혈청IL-2、IL-6화TNF-α농도[(987±203)、(277±107)、(197±98) ng/L]명현저우대조조[(1347±195)、(752±187)、(342±106) ng/L](P＜ 0.05);량조술후1d외주혈IgG、IgA、IgM、CD3+、CD4+、CD8+수평균유불동정도하강,수후축점회승,관찰조술후7d외주혈IgG、CD3+、CD4+수평[(14.2±1.8) g/L、0.746±0.111、0.580±0.067]교대조조[(12.1±2.8) g/L、0.606±0.101、0.404±0.072]명현승고(P＜0.05).결론 결구지방유능감경소화도종류술후환자면역억제,감경염성반응,조공염성세포인자적산생화석방,개선궤체면역공능.
Objective To explore the influence of structured lipid emulsion on inflammatory cell factors and immunologic function in gastrointestinal cancer patients after operation.Methods From July 2010 to February 2012,80 postoperative patients with gastrointestinal cancer were randomly divided into 2 groups with 40 cases each by stratified sampling method:structured lipid emulsion group (observation group),physical mixture of medium-chain/long-chain triglycerides group (control group).Both groups received isonitrogenous and isocaloric parenteral nutrition for 6 days after operation.The general conditions after operation were compared between two groups.Inflammatory cell factors and immunologic function were measured before operation,the 1st day and 7th day after operation.Results After 6 days parenteral nutrition,the vital sign data,blood routine,liver and renal function,blood fat etc was normal in two groups.There was no significant difference in the incidence of postoperative infection complication and hospitalization duration between observation group and control group [12.5％(5/40) vs.25.0％(10/40),[( 12.9 ± 0.7 d) vs.(13.1 ±0.9) d] (P ＞0.05).The serum levels of interleukin (IL)-1,IL-2,IL-6,tumor necrosis factor (TNF)-α on the 1st day after operation in two groups decreased,then gradually increasing.The serum levels of IL-2,IL-6,TNF- α on the 7th day after operation in observation group[(987 ± 203),(277 ± 107),( 197 ± 98) ng/L] were lower than those in control group [(1347 ± 195),(752 ± 187),(342 ± 106) ng/L](P＜0.05 ).The serum levels of IgG,IgA,IgM,CD3+,CD4+ and CD8+ on the 1st day after operation in two groups decreased,then gradually increasing.The serum levels of IgG,CD3+,CD4+ were higher in observation group [( 14.2 ± 1.8 ) g/L,0.746 ± 0.111,0.580 ± 0.067] than those in control group [( 12.1 ± 2.8) g/L,0.606 ±0.101,0.404 ± 0.072] (P ＜0.05).Conclusion Structured lipid emulsion can reduce immunological suppression and inflammation in gastrointestinal cancer patients after operation,regulate the inflammatory cell factors producing and releasing,improve the immunologic function.
