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目的探讨氨基酸肠外营养支持对中晚期非小细胞肺癌(NSCLC)化疗患者血清中褪黑素(MT)和色氨酸(Try)水平的影响。方法将72例不能手术的中晚期NSCLC患者分为3组,统一采用NP方案(顺铂+去甲长春花碱)进行3个周期的化疗,A组和B组患者在化疗的同时分别给予250和500ml/d的9-复合氨基酸(9AA)营养支持,C组仅行化疗。测定3组患者治疗前后血清MT和Try的浓度。结果治疗后中午12∶00时,A、B和C组患者血清MT分别为(3．3±2．7)、(5．4±5．2)和(3．0±3．1)pg/ml,夜间0∶00时分别为(30．1±4．9)、(30．7±9．5)和(17．1±6．5)pg/ml。治疗后中午12∶00时,A、B和C组患者血清Try分别为(31．3±16．6)、(38．3±17．3)和(20．7±12．5) pg/ml,夜间0∶00时分别为(15．4±5．4)、(18．6±7．6)和(12．2±9．9)pg/ml。A、B组血清MT和Try浓度高于C组(P＜0．05),且500ml/d氨基酸营养支持的B组高于250ml/d氨基酸营养支持的A组(P＜0．05)。结论氨基酸肠外营养支持有利于纠正化疗后中晚期NSCLC患者血清MT和Try水平的低下,且500ml/d的氨基酸肠外营养支持效果较为显著。
Objective To investigate the effects of amino acid parenteral nutrition support on the levels of melatonin (MT) and tryptophan (Try) in the serum of patients with advanced non-small cell lung cancer (NSCLC). Methods Seventy-two inoperable patients with advanced NSCLC were divided into 3 groups. The NP regimen (cisplatin + norvinbine) was used for 3 cycles of chemotherapy. Patients in group A and B were given 250 concurrently with chemotherapy. With 9-complex amino acid (9AA) nutritional support of 500ml/d, group C only received chemotherapy. The serum MT and Try concentrations were measured before and after treatment in the 3 groups of patients. Results After treatment at 12:00 noon, serum MT in patients A, B, and C were (3.3±2.7), (5.4±5.2), and (3.0±3.1) pg, respectively. /ml, 0:00 at night, respectively (30.1 ± 4.9), (30.7 ± 9.5) and (17.1 ± 6.5) pg/ml. At 12:00 noon after treatment, serum Try in groups A, B, and C was (31.3±16.6), (38.3±17.3), and (20.7±12.5) pg/ Ml, at 0:00 pm, were (15.4 ± 5.4), (18.6 ± 7.6), and (12.2 ± 9.9) pg/ml, respectively. The concentrations of serum MT and Try in group A and B were higher than those in group C (P<0.05), and the nutritional support in 500 ml/d amino acid group was higher than that in 250 ml/d amino acid nutritional group A (P<0.05). Conclusion The amino acid parenteral nutrition support is beneficial to correct the low level of serum MT and Try in patients with advanced NSCLC after chemotherapy, and the support effect of 500 ml/d amino acid parenteral nutrition is more significant.