Effects of perioperative glutamine-supplemented total parenteral nutrition support on immune function of patients with gastrointestinal cancer / 肠外与肠内营养

ABSTRACT

Objective:To evaluate the perioperative effects of glutamine-supplemented total parenteral nutrition support on immune function of patients with gastrointestinal cancer.Methods:60 patients with gastrointestinal cancer randomized into three groups.The groups of A(standard TPN group)and B(glutamine-supplemented TPN group) were given an isocaloric 104.6 kJ/(kg?d) and isonitrogenous 0.20 g/(kg?d)total parenteral nutrition for 10 days(5 days before operation and 5 days after operation) together with a course of chemotherapy before operation lasting 5 days.The 25%～35% of nitrogenous source of group B was supplied by glutamine dipeptiven.The group of C(control group) was treated by routine program.All variables were measured before and after operaition.Immune function and inflammatory responses were investigated.Results:No serious complication occurred in any group during the trial.The percentages of CD3~(+)cell and CD8~(+) cell decreased in three groups after operation.The percentage of CD4~(+)cell and NK cell and the ratio of CD4~(+)/CD8~(+) of group B was the highest in the three group on the sixth day after operation.Total lymphocyte count was higher in group B than that in group A and the levels of C reactive protein and prostaglandin E_(2) in group B were lower than those in group A.Conclusions:Glutamine-supplemented TPN is beneficial in raising total lymphocyte count and decreasing the level of C reactive protein and prostaglandin E_(2).And it can also modulate immunosuppressive status and inflammatory response of postoperative patients.