围手术期免疫营养对进展期胃癌患者血小板吞噬活性的影响。

The effect of perioperative immunonutrition on the phagocytic activity of blood platelets in advanced gastric cancer patients.

作者信息

Kamocki Zbigniew, Matowicka-Karna Joanna, Gryko Mariusz, Zareba Konrad, Kedra Boguslaw, Kemona Halina

机构信息

2nd Department of General and Gastroenterological Surgery, Medical University of Bialystok, M. Sklodowskiej-Curie 24A Street, 15-276 Bialystok, Poland.

Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, Poland.

出版信息

Clin Dev Immunol. 2013;2013:435672. doi: 10.1155/2013/435672. Epub 2013 Dec 1.

DOI:10.1155/2013/435672

PMID:24363760

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3864072/

Abstract

BACKGROUND AND AIMS

Perioperative immunonutrition can influence the phagocytic activity of platelets in advanced gastric cancer.

METHODS

51 patients with stage IV gastric cancer divided into four groups depending on the clinical status and 40 normal donors were analyzed. Patients of groups I and II underwent palliative gastrectomy. Patients of groups III and IV had exploratory laparotomy. Perioperative immunonutrition was administered as follows: group I--TPN, II--oral arginine, peripheral TPN, III--TPN preoperatively, and IV--without nutrition. The phagocytic activity of blood platelets was determined before and after nutritional therapy and was assessed by measuring the fraction of phagocytic thrombocytes (%phag) and the phagocytic index (Ixphag).

RESULTS

The percentage of phagocytizing platelets and the phagocytic index prior to and after the surgery amounted to the following: group I--1.136-1.237, P = NS, and 1.007-1.1, P = NS, respectively, II--1.111-1.25, P < 0.05, and 1.011-1.083, P < 0.05, III--1.112-1.186, P = NS, and 0.962-1.042, P = NS, and IV--1.085-0.96, P = NS, and 1.023-1.04, P = NS.

CONCLUSIONS

The phagocytic activity of platelets in patients with advanced gastric cancer is significantly impaired. Perioperative immunonutrition with oral arginine-rich diet can partially improve the phagocytic activity of blood platelets. This trial is registered with Clinicaltrials.gov--NCT01704664.

摘要

背景与目的

围手术期免疫营养可影响进展期胃癌患者血小板的吞噬活性。

方法

根据临床状况将51例IV期胃癌患者分为四组，并分析了40名正常供体。I组和II组患者接受姑息性胃切除术。III组和IV组患者进行了剖腹探查术。围手术期免疫营养给药如下：I组——全胃肠外营养（TPN），II组——口服精氨酸、外周静脉TPN，III组——术前TPN，IV组——无营养支持。在营养治疗前后测定血小板的吞噬活性，并通过测量吞噬性血小板的比例（%吞噬）和吞噬指数（Ixphag）进行评估。

结果

手术前后吞噬血小板的百分比和吞噬指数如下：I组分别为1.136 - 1.237，P =无统计学意义（NS），以及1.007 - 1.1，P = NS；II组分别为1.111 - 1.25，P < 0.05，以及1.011 - 1.083，P < 0.05；III组分别为1.112 - 1.186，P = NS，以及0.962 - 1.042，P = NS；IV组分别为1.085 - 0.96，P = NS，以及1.023 - 1.04，P = NS。