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[围手术期肠外营养对胃癌患者免疫能力的影响]

[Effects of perioperative parenteral nutrition on immunocompetence in patients with gastric cancer].

作者信息

Yan M

机构信息

Ruijin Hospital, Shanghai Second Medical University.

出版信息

Zhonghua Wai Ke Za Zhi. 1990 Dec;28(12):739-41, 782.

PMID:2128263
Abstract

To elucidate the effects of parenteral nutrition on the immunocompetence, we administrated parenteral nutritional support to the malnourished gastric cancer patients during perioperative periods. Changes of peripheral blood natural killer cytotoxicity (NKC) activity (LDH enzyme-release assay) and T lymphocyte subsets (OKT series monoclone antibody indirect fluorescent assay) were monitored before and after nutritional support. The results showed that one week of pre or postoperative parenteral nutrition significantly increased the NKC activity, T-helper, and T-helper/T-suppressor ratio. The total T lymphocytes count may also increase. T-suppressors remained unchanged no matter whether nutritional support was given or not. The authors believe that perioperative nutritional support could improve the immunocompetence of gastric cancer patients to some extent, and promote the restoration of immune depression caused by operation, but it could not eliminate the effects of immune depressing factor produced by the tumor. Intralipid can be used properly as non protein energy source without immunodepressing effects.

摘要

为阐明肠外营养对免疫能力的影响,我们在围手术期对营养不良的胃癌患者给予肠外营养支持。在营养支持前后监测外周血自然杀伤细胞毒性(NKC)活性(乳酸脱氢酶酶释放试验)和T淋巴细胞亚群(OKT系列单克隆抗体间接荧光试验)的变化。结果显示,术前或术后一周的肠外营养显著提高了NKC活性、辅助性T细胞以及辅助性T细胞/抑制性T细胞的比例。总T淋巴细胞计数也可能增加。无论是否给予营养支持,抑制性T细胞均保持不变。作者认为,围手术期营养支持可在一定程度上改善胃癌患者的免疫能力,并促进手术所致免疫抑制的恢复,但无法消除肿瘤产生的免疫抑制因子的影响。脂肪乳剂可作为非蛋白质能量来源合理使用,且无免疫抑制作用。

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