| 刘国辉,康新,陈功,等.肠内营养对放射性肠炎患者肠屏障功能及机体免疫反应的影响[J].中华放射医学与防护杂志,2012,32(6):612-615.LIU Guo-hui,KANG Xin,CHEN Gong,et al.Influence of intestinal early enteral nutrition therapy on intestinal barrier function and immune response of patients with radiation enteritis[J].Chin J Radiol Med Prot,2012,32(6):612-615 |
| 肠内营养对放射性肠炎患者肠屏障功能及机体免疫反应的影响 |
| Influence of intestinal early enteral nutrition therapy on intestinal barrier function and immune response of patients with radiation enteritis |
| 投稿时间：2012-03-29 |
| DOI：10.3760/cma.j.issn.0254-5098.2012.06.013 |
| 中文关键词: 肠内营养 放射性肠炎 肠屏障功能 免疫反应 |
| 英文关键词:Enteral nutrition Radiation enteritis Intestinal barrier function Immune response |
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| 中文摘要: |
| 目的 探讨早期肠内营养对放射性肠炎患者肠屏障功能及机体免疫反应的影响。方法 将经肠镜、X射线及病理检查,确诊为放射性肠炎的56例患者按随机数字表法分成实验组及对照组,每组28例。实验组行肠内营养支持治疗,对照组常规治疗。检测肠屏障功能指标、外周血免疫球蛋白(IgG、IgM、IgA)、T淋巴细胞亚群CD4/CD8比值;2次术后送病理光镜下测量每厘米肠黏膜厚度及绒毛的高度。结果 肠屏障功能各项指标11 d时两组间差异有统计学意义(t值分别为DAO 2.568,L/M比值2.427,D-乳酸2.143,内毒素水平2.443, P<0.05),21 d时两组间差异也有统计学意义(t:DAO6.019,L/M比值12.834,D-乳酸7.837,内毒素水平7.997, P<0.01);各项免疫指标1 d时差异无统计学意义(P＞0.05),11 d实验组IgG、IgM、IgA及 CD4/CD8比值与对照组比较差异有统计学意义(t值分别为:IgG 2.096,IgM 2.211,IgA 2.182,CD4/CD8比值2.301, P< 0.05),21 d时较对照组显著增高(t值分别为:IgG 2.703,IgM 2.679,IgA 3.138,CD4/CD8比值5.107,P< 0.01);2次术后肠黏膜厚度及肠绒毛高度出现明显差异。结论 早期肠内营养支持治疗可明显降低放射性肠炎患者DAO、D-乳酸、内毒素水平,提高IgG、IgM、IgA及CD4/CD8水平,在一定程度上保护了肠屏障功能和机体免疫功能。 |
| 英文摘要: |
| Objective To investigate the influence of early enteral nutrition therapy on the intestinal barrier function and immune response of the patients with radiation enteritis (ER) so as to find a relatively simple and effective method to treat RE. Methods Fifty-six patients with radiation enteritis (RE) diagnosed by colonoscopy, X-rays, and pathology were randomly divided into 2 equal groups: experimental group undergoing enteral inutrition therapy, and control group undergoing conventional therapy only. Peripheral blood samples were collected 1, 11, and 21 days after admission. Plasma diamine oxidase (DAO), D-lactic acid, endotoxin, and lactulose/mannitol (L/M) ratio, and levels of IgG, IgM, and IgA, and CD4／CD8 ratio were examined. Five cases from the experimental group and 5 cases from the control group underwent second-time operation because of incomplete intestinal obstruction, intestinal stenosis, or recurrent tumor respectively. The biopsy specimens of the terminal ileum or distal descending colon taken during the first and second operations underwent pathological examination. Peripheral blood samples were collected 1, 11, and 21 days after admission. Plasma diamine oxidase (DAO), D-lactic acid, endotoxin, and lactulose/mannitol (L/M) ratio, and levels of IgG, IgM, and IgA, and CD4／CD8 ratio were examined. Results There were no significant differences in the intestinal function and blood immunological indices between these 2 groups. The levels of DAO, D-lactic acid, and endotoxin, and the L/M ratio 11 days after admission of the experiment group were all significantly lower than those of the control group (t=2.568, 2.427,2.143, 2.443, P< 0.05), and all those indices 21 days after admission of the experiment group were all much more significantly lower in comparison with the control group (t=6.019, 12.834, 7.837, 7.997, P< 0.01). The levels of IgG, IgM, and IgA, and CD4/CD8 ratio 11 days after admission of the experimental group were all significantly higher than those of the control group (t=2.096, 2.211, 2.182, P< 0.05, and t=2.301,P< 0.05), and the differences became much more significant 21 days after admission (t=2.703, 2.679, 3.138, P< 0.01, and t=5.107,P< 0.01). The height of the intestinal villa and the thickness of the mucosa of the specimens taken at the second-time operation were both much greater than those at the first-time operation. Conclusion Early enteral support therapy helps effectively maintain the intestinal barrier and immune response function of the RE patients. |
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