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目的:探讨不同剂量精氨酸(Arg)强化的肠外营养(TPN)对胃肠癌患者术后免疫功能的影响。方法:选择90例胃肠癌患者,术后分别给予肠外营养支持,随机分为对照组(常规TPN,30例),试验Ⅰ组(TPN+Arg 15 g,30例)和试验Ⅱ组(TPN+Arg 30 g,30例),分析术前术后不同时期白蛋白、总蛋白、C3、C4、CD4+、CD8+、CD4+/CD8+等免疫功能指标变化。结果:与对照组相比,Arg强化的TPN试验组患者免疫功能在术后第4天均有明显改善(P<0.05),随着精氨酸剂量的增加,总蛋白、CD4+、CD8+、CD4+/CD8+等指标改善更为显著(P<0.01)。结论:精氨酸强化的TPN能提高胃肠癌患者术后免疫功能,添加精氨酸30 g优于15 g。
Objective: To investigate the effects of different doses of arginine (Arg) enhanced parenteral nutrition (TPN) on postoperative immune function in patients with gastrointestinal cancer. Methods: Totally 90 patients with gastrointestinal cancer were enrolled. After operation, they were given parenteral nutrition support and were randomly divided into control group (conventional TPN, 30 cases), test group Ⅰ (TPN + Arg 15 g, 30 cases) and test group Ⅱ TPN + Arg 30 g, 30 cases). The changes of immune function indexes such as albumin, total protein, C3, C4, CD4 +, CD8 +, CD4 + / CD8 + were analyzed before and after operation. Results: Compared with the control group, the immune function of Arg-enhanced TPN test group was significantly improved on the 4th postoperative day (P <0.05). The total protein, CD4 +, CD8 +, CD4 + / CD8 + and other indicators to improve more significantly (P <0.01). CONCLUSION: Arginine-enriched TPN can improve postoperative immune function in patients with gastrointestinal cancer. The addition of arginine 30 g is better than 15 g.