| 谷氨酰胺强化肠内营养对胃癌术后免疫功能影响的Meta分析 |
| Alternative Title | Meta-analysis of the effect of glutamine enhanced enteral nutrition on immune function in patients with gastric cancer
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| 杨屹立 |
| Thesis Advisor | 郭天康
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| 2015-05-20
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 谷氨酰胺
肠内营养
胃癌术后
免疫功能
Meta分析
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| Abstract | 目的 系统评价谷氨酰胺强化肠内营养对胃癌患者术后免疫功能的影响。
方法 检索Cochrane Library、PubMed、EMbase、CNKI、万方和CBM，同时手工检索相关文献和会议论文集，收集所有国内外公开发表的有关于谷氨酰胺强化肠内营养对胃癌患者术后免疫功能影响的随机对照试验。按照纳入和排除标准选择文献，使用RevMan5.3版统计软件进行Meta分析。
结果 最终共纳入8项随机对照试验，共计459例胃癌患者，Meta分析结果显示：1）谷氨酰胺强化肠内营养组与常规肠内营养组术前1天CD4+含量的差异无统计学意义（P>0.05），术后1～3天、7～10天谷氨酰胺强化肠内营养组CD4+含量均高于常规肠内营养组，其差异有统计学意义（P<0.05）。2）谷氨酰胺强化肠内营养组与常规肠内营养组术前1天、术后1～3天CD8+含量的差异均无统计学意义（P>0.05），术后7～10天谷氨酰胺强化肠内营养组CD8+含量高于常规肠内营养组，其差异有统计学意义（P<0.05）。3）谷氨酰胺强化肠内营养组CD4+/CD8+比值术前1天、术后1～3天、术后7～10天均高于常规肠内营养组，其差异有统计学意义（P<0.05）。4）谷氨酰胺强化肠内营养组与常规肠内营养组术前1天、术后1～3天IgG含量的差异均无统计学意义（P>0.05），术后7～10天谷氨酰胺强化肠内营养组IgG含量高于常规肠内营养组，其差异有统计学意义（P<0.05）。5）谷氨酰胺强化肠内营养组与常规肠内营养组术前1天、术后1～3天IgM含量的差异均无统计学意义（P>0.05），术后7～10天谷氨酰胺强化肠内营养组IgM含量高于常规肠内营养组，其差异有统计学意义（P<0.05）。6）谷氨酰胺强化肠内营养组与常规肠内营养组术前1天、术后1～3天IgA含量的差异均无统计学意义（P>0.05），术后7～10天谷氨酰胺强化肠内营养组IgA含量高于常规肠内营养组，其差异有统计学意义（P<0.05）。7）谷氨酰胺强化肠内营养组与常规肠内营养组并发症发生率、肛门排气时间的差异无统计学意义（P>0.05），而谷氨酰胺强化肠内营养组较常规肠内营养组住院天数少，差异有统计学意义（P<0.05）。
结论 谷氨酰胺强化肠内营养可改善和增强胃癌患者术后应激状态下的免疫功能，并能缩短患者住院时间，减轻患者经济负担。 |
| Other Abstract | Objective To evaluate the impact of the glutamine enhanced enteral nutrition on immune function for the gastric cancer.
Methods The published studies were searched in Cochrane Library，PubMed, Embase，CNKI， WanFang Database and CBM from inception to Feb 2，2014，and other relevant references of the included literature were also searched to collect all the randomized controlled trials. Studyies were screened according to the inclusion and exclusion criteria，data were extracted，the methodological quality of the included studies was assessed，and meta-analyses were performed with RevMan 5.3 software.
Results A total of eight randomized controlled trials involving 459 patients were included in the study. The results of meta—analysis showed：1）There was no statistical significant difference in CD4+ of preoperative 1 day between two groups，but the glutamine enhanced enteral nutrition were significantly higher than conventional enteral nutrition in CD4+ after 1 to 3、7 to 10 days of gastric surgery. 2) There was no statistical significant difference in CD8+ of preoperative 1 day、after 1 to 3 days of gastric surgery between two groups，the glutamine enhanced enteral nutrition were significantly higher than conventional enteral nutrition in CD8+ after 7 to 10 days of gastric surgery. 3）The glutamine enhanced enteral nutrition were significantly higher than conventional enteral nutrition in CD4+/CD8+ preoperative 1 day， after 1 to 3、7 to 10 days of gastric surgery. 4）There was no statistical significant difference in IgG of preoperative 1 day、after 1 to 3 days of gastric surgery between two groups，the glutamine enhanced enteral nutrition were significantly higher than conventional enteral nutrition in IgG after 7 to 10 days of gastric surgery. 5）There was no statistical significant difference in IgM of preoperative 1 day、after 1 to 3 days of gastric surgery between two groups，the glutamine enhanced enteral nutrition were significantly higher than conventional enteral nutrition in IgM after 7 to 10 days of gastric surgery. 6）There was no statistical significant difference in IgA of preoperative 1 day、after 1 to 3 days of gastric surgery between two groups，the glutamine enhanced enteral nutrition were significantly higher than conventional enteral nutrition in IgA after 7 to 10 days of gastric surgery. 7）The postoperative complications and the time to first flatus showed no significant difference between the glutamine enhanced enteral nutrit... |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/223394
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
杨屹立. 谷氨酰胺强化肠内营养对胃癌术后免疫功能影响的Meta分析[D]. 兰州. 兰州大学,2015.
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