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目的观察结构脂肪乳(STG)、中/长链脂肪乳(MCT/LCT)和长链脂肪乳(LCT)对胃肠道肿瘤患者术后细胞免疫功能的影响。方法选择2008年8月至11月间收治的64例经病理证实为胃肠道肿瘤的患者,采用信封法随机分为3组:STG组22例、MCT/LCT组22例和LCT组20例。术后1~5d接受等氮、等热量的PN支持。观察患者术前、术后第1天及第6天外周血T淋巴细胞亚群CD3~+、CD4~+、CD8~+比率及CD4~+/CD8~+比值的变化。结果术后第1天,3组患者CD3~+、CD4~+比率及CD4~+/CD8~+比值均有所下降;术后第6天,STG组和MCT/LCT组CD3~+、CD4~+比率及CD4~+/CD8~+比值上升,而LCT组上升不明显,且STG组与LCT组差异有统计学意义。结论术后早期应用结构脂肪乳支持能够改善患者的细胞免疫功能,促进患者术后康复。
Objective To observe the effect of structured fat emulsion (STG), medium / long chain fat emulsion (MCT / LCT) and long chain fat emulsion (LCT) on cellular immune function in patients with gastrointestinal cancer. Methods Sixty-four patients with pathologically confirmed gastrointestinal tumors admitted between August and November 2008 were randomly divided into three groups: 22 in the STG group, 22 in the MCT / LCT group and 20 in the LCT group . 1-5 days after receiving nitrogen and other heat PN support. The changes of CD3 +, CD4 +, CD8 + and CD4 ~ + / CD8 + ratio in peripheral blood T lymphocyte subsets were observed before operation and on the first day and the sixth day after operation. Results On the first day after operation, the ratio of CD3 +, CD4 + and CD4 + / CD8 + decreased in all three groups. On the 6th day after operation, the levels of CD3 +, CD4 ~ + Ratio and CD4 ~ + / CD8 ~ + ratio increased, while the LCT group did not increase significantly, and STG group and LCT group was statistically significant. Conclusion The application of structural lipid emulsion in the early postoperative period can improve cellular immune function and promote postoperative recovery.