肠内营养对胰十二指肠切除术后急性炎症、免疫细胞和脂质代谢的影响

Jianping Cai, Xiang-feng Zhou, Haibo Yu, Lian-cai Wang, Deyu Li
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引用次数: 0

摘要

目的研究不同肠外营养对胰十二指肠切除术后急性炎症反应、免疫细胞和脂质代谢的影响。方法将80例胰十二指肠切除术后患者分为研究组和对照组,每组40例。研究组采用结构脂肪乳,对照组采用中/长链脂肪乳。比较两组患者急性炎症、免疫细胞及脂质代谢的变化。结果(1)两组患者术后第1天C反应蛋白(CRP)和血清前列腺素E2(PGE2)水平均明显高于术前。两组比较差异有统计学意义(P<0.05)。术后第7天CRP和PGE2水平降至术前水平,但研究组下降速度明显快于对照组(P<0.05),研究组CD4+/CD8+明显高于对照组(P<0.05),显著降低血脂水平。关键词:胰十二指肠切除术;肠外营养;C反应蛋白
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Effects of enteral nutrition on acute inflammation, immune cells and lipid metabolism in patients after pancreaticoduodenectomy
Objective To study the effects of different parenteral nutrition on acute inflammatory response, immune cells and lipid metabolism in patients after pancreaticoduodenectomy. Methods Eighty patients after pancreaticoduodenectomy were divided into study group and control group, with 40 cases in each group. Structural fat emulsion was used in study group and medium/long chain fat emulsion in control group. The changes of acute inflammation, immune cells and lipid metabolism were compared between the two groups. Results (1)The levels of C-reactive protein (CRP) and serum prostaglandin E2 (PGE2) in the two groups were significantly higher on the first day after operation than those before operation. The difference between the two groups was statistically significant (P<0.05). The level of CRP and PGE2 decreased to the preoperative level on the seventh day after operation, but the decline rate in the study group was significantly faster than that in the control group (P<0.05). (2)The levels of CD3+ , CD4+ , CD8+ , CD4+ /CD8+ in the study group were significantly higher than those in the control group (P<0.05). (3)After 3-7 days of intravenous parenteral nutrition infusion, the blood lipid level was significantly lower in study group (P<0.05). Conclusion Structural fat emulsion alleviates the inflammatory reaction in patients after pancreaticoduodenectomy, promotes the recovery of immunity, significantly reduces the level of blood lipids. Key words: Pancreaticoduodenectomy; Parenteral nutrition; C-reactive protein
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