摘要
目的探讨肠内营养联合皮下注射胸腺肽α1对老年胃肠道恶性肿瘤患者免疫功能、营养状况和炎性反应的影响。方法选取2018年12月至2020年1月解放军总医院第三医学中心普外科老年胃肠道恶性肿瘤患者42例为研究对象,按照随机双盲原则将入选患者分为观察组(22例)和对照组(20例)。对照组患者行肠内营养支持治疗,观察组患者行肠内营养联合皮下注射胸腺肽α1,比较两组患者治疗前后营养指标(白蛋白、前白蛋白、运铁蛋白)、免疫指标[CD4+T细胞、CD8+T细胞、CD4+T细胞/CD8+T细胞比值、自然杀伤细胞(natural killer cell,NK细胞)]、炎症指标[白介素-6(interleukin-6,IL-6)、肿瘤坏死因子(tumor necrosis factor,TNF)、C反应蛋白(C reactive protein,CRP)]的差异。结果治疗后,两组患者白蛋白、前白蛋白、运铁蛋白水平均显著高于本组治疗前(均P<0.05),但组间比较差异均无统计学意义(均P>0.05)。治疗后,两组患者CD4+T细胞、CD4+T细胞/CD8+T细胞比值、NK细胞水平均显著高于本组治疗前(均P<0.05),且观察组患者上述指标水平均显著高于对照组(均P<0.05)。治疗后,两组患者CRP、TNF、IL-6水平均显著低于本组治疗前(均P<0.05),且观察组患者上述指标水平均显著低于对照组(均P<0.05)。结论与单纯肠内营养相比,肠内营养联合皮下注射胸腺肽α1能够提高老年胃肠道恶性肿瘤患者的免疫功能,降低炎性反应。
Objective To evaluate the effect of enteral nutrition combined with subcutaneous injection of thymosinα1 interv ention on immune function trophic status and inflammatory reaction in elderly patients with malignant gastrointestinal tumor.Method Forty-two elderly patients with malignant gastrointestinal tumor in the Department of General Surgery of Third Medical Center of PLA General Hospital from December 2018 to January 2020 were divided into control group(n=20)and treatment group(n=22)according to the random double blind principle.Patients in control group received enteral nutrition intervention,while patients in treatment group received enteral nutrition combined with subcutaneous injection of thymosinα1 intervention,the differences of nutritional indexes(albumin,prealbumin,transferrin),immune indexes[CD4+T cell,CD8+T cell,CD4+T cell/CD8+T cell ratio,natural killer cell(NK cell)]and inflammatory indexes[interleukin-6(IL-6),tumor necrosis factor(TNF),C reactive protein(CRP)]between the two groups before and after treatment were compared.Result After treatment,the levels of albumin,prealbumin and transferrin in the two groups were significantly higher than those before treatment(all P<0.05),but there were no significant differences between the two groups(all P>0.05).After treatment,the levels of the CD4+T cells,CD4+T cells/CD8+T cells ratio and NK cells in the two groups were significantly higher than those before treatment(all P<0.05),and the levels of the above indexes in treatment group were significantly higher than those in control group(all P<0.05).After treatment,the levels of CRP,TNF and IL-6 in the two groups were significantly lower than those before treatment(all P<0.05),and the levels of the above indexes in treatment group were significantly lower than those in control group(all P<0.05).Conclusion Compared with enteral nutrition alone,enteral nutrition combined with subcutaneous injection of thymosinα1 intervention can improve the immune function and reduce inflammatory reaction in elderly patients with malignant gastrointestinal tumor.
作者
苗山
史宏志
刘昕炜
高宏凯
Miao Shan;Shi Hongzhi;Liu Xiwei;Gao Hongkai(Department of General Surgery,Third Medical Center of PLA General Hospital,Beijing 100039,China)
出处
《肿瘤综合治疗电子杂志》
2020年第4期49-52,共4页
Journal of Multidisciplinary Cancer Management(Electronic Version)
基金
武警部队高层次人才技术专家培养专项(2013-GCCRC-04)。
关键词
老年
胃肠道恶性肿瘤
肠内营养
胸腺肽Α1
细胞免疫
Elderly
Malignant gastrointestinal tumor
Enteral nutrition
Thymosinα1
Cellular immunity
