Wang Xuefeng, Huang Lei, Qu Yanxia, Lv Hongmei, He Xiaohua
Department of Rehabilitation, Daqing Oilfield General Hospital, Daqing, Heilongjiang 163001, P.R. China.
Exp Ther Med. 2018 Sep;16(3):2303-2308. doi: 10.3892/etm.2018.6443. Epub 2018 Jul 13.
This study was designed to investigate the effects of glutamine on cytokines 1L-1, TNF-α and prognosis of patients with lobectomy in the process of postoperative rehabilitation. A total of 78 patients with lung cancer who underwent lobectomy from January 2015 to January 2017 were selected in Daqing Oilfield General Hospital (Daqing, China). Patients were randomly divided into two groups, 39 patients in each group. Patients in the control group were treated with conventional treatment, while patients in the observation group were treated with both conventional and glutamine treatment. The levels of TNF-α, endotoxin, serum IL-1, IL-10, IL-15, IL-18 and intercellular adhesion molecule-1 (ICAM-1), myeloperoxidase (MPO) activity, incidence of nausea and vomiting, pulmonary histopathological changes, prognosis, and rehabilitation (time in bed, hospital stay and lung function) were compared between the two groups. Within 1 year after treatment, most patients survived, except 2 patients in the observation group and 3 patients in the control group who died. The rate of postoperation infection in the observation group was slightly lower than that in the control group. After treatment, the levels of endotoxin and TNF-α in the observation group were significantly lower than those in the control group (p<0.05). After treatment, the serum levels of IL-1 and IL-10 were significantly higher and the serum levels of IL-15 and IL-18 were significantly lower in the observation group than those in the control group (p<0.05). The expression levels of ICAM-1 and MPO activity were significantly higher in the observation group than those in the control group (p<0.05). No significant difference in the incidence of nausea and vomiting was found between the two groups (p>0.05). The average postoperative bed rest and hospital stay in the observation group were significantly shorter than those in the control group (p<0.05). The levels of forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR) in the observation group were significantly higher than those in the control group (p<0.05). The results indicated that glutamine treatment is effective in the postoperative rehabilitation of patients undergoing lobectomy. Glutamine can regulate the levels of IL-1 and TNF-α, improve lung function, shorten bed rest and hospitalization days, promote patients postoperative rehabilitation process, and improve patients quality of life.
本研究旨在探讨谷氨酰胺对肺叶切除患者术后康复过程中细胞因子白细胞介素 -1（IL-1）、肿瘤坏死因子 -α（TNF-α）及预后的影响。选取2015年1月至2017年1月在大庆油田总医院（中国大庆）行肺叶切除的78例肺癌患者。患者随机分为两组，每组39例。对照组患者接受常规治疗，观察组患者接受常规治疗加谷氨酰胺治疗。比较两组患者的TNF-α、内毒素、血清IL-1、IL-10、IL-15、IL-18及细胞间黏附分子 -1（ICAM-1）水平、髓过氧化物酶（MPO）活性、恶心呕吐发生率、肺组织病理学变化、预后及康复情况（卧床时间、住院时间和肺功能）。治疗后1年内，多数患者存活，观察组2例患者及对照组3例患者死亡。观察组术后感染率略低于对照组。治疗后，观察组内毒素和TNF-α水平显著低于对照组（p<0.05）。治疗后，观察组血清IL-1和IL-10水平显著高于对照组，血清IL-15和IL-18水平显著低于对照组（p<0.05）。观察组ICAM-1表达水平和MPO活性显著高于对照组（p<0.05）。两组恶心呕吐发生率差异无统计学意义（p>0.05）。观察组术后平均卧床时间和住院时间显著短于对照组（p<0.05）。观察组第1秒用力呼气量（FEV1）、用力肺活量（FVC）和呼气峰值流速（PEFR）水平显著高于对照组（p<0.05）。结果表明，谷氨酰胺治疗对肺叶切除患者术后康复有效。谷氨酰胺可调节IL-1和TNF-α水平，改善肺功能，缩短卧床和住院天数，促进患者术后康复进程，提高患者生活质量。
