食管癌根治术后经空肠造瘘管肠内营养对免疫应答、肠黏膜屏障功能的影响

摘要

Objective:To study the effects of enteral nutrition via jejunostomy catheter on immune response and intesti-nal mucosal barrier function after radical operation for esophageal cancer.Methods:A total of 90 patients who were diagnosed with esophageal cancer and received radical operation in Xishui People's Hospital between February 2015 and May 2017 were se-lected and randomly divided into the EN group who accepted enteral nutrition via jejunostomy catheter and the PN group who received parenteral nutrition.1 week and 2 weeks after surgery,the expression of immune cell transcription factors in peripher-al blood as well as the contents of intestinal mucosal injury markers and inflammatory stress markers in serum were measured. Results:1 week and 2 weeks after surgery,T-bet expression intensity in peripheral blood of EN group was greatly higher than that of PN group while GATA3,RORγt and Foxp3 expression intensity in peripheral blood as well as DAO,Galectin-1,Ga-lectin-3,Claudin,NE,E,Cor,CRP and CER levels were greatly lower than those of PN group.Conclusion:Enteral nutrition via jejunostomy catheter can improve the immune response and intestinal mucosal barrier function after radical operation for e-sophageal cancer.%目的:研究食管癌根治术后经空肠造瘘管肠内营养对免疫应答、肠黏膜屏障功能的影响.方法:选择2015年2月~2017年5月期间在浠水县人民医院诊断为食管癌并接受根治性手术的90例患者,随机分为接受术后经空肠造瘘管肠内营养的EN 组以及接受肠外营养的 PN 组.术后1周时和2周时,测定外周血中免疫细胞转录因子的表达量以及血清中肠黏膜损伤标志物、炎症应激标志物的含量.结果:术后1周时和2周时,EN 组患者外周血中 T-bet 的表达强度显著高于对照组,外周血中GA-TA3、RORγt、Foxp3的表达强度以及血清中DAO、Galectin-1、Galectin-3、Claudin、NE、E、Cor、CRP、CER的含量显著低于PN组.结论:食管癌根治术后经空肠造瘘管肠内营养能够改善免疫应答、肠黏膜屏障功能.