腸道灌食免疫配方對腹部手術病患免疫反應之影響

(1)



本試驗是探討腹部開刀的腸道灌食病患以添加魚油的免疫管灌配方探討其免疫反應之影響。經收案標準評估後將受試者分為兩組，一組給予含有魚油的免疫管灌配方 IMPACT-Glutamine® (n=7) ，另一組給予等熱量 (30 卡 / 公斤體重 ) 不含魚油的免疫管灌配方 Alitraq® (n=7) ，病患之疾病嚴重度 (APACHE II Score) 均小於 15 ，在開始灌食前一天及灌食後第七天各測其免疫反應： CD4 、 CD8 、 CD4/CD8 、 C3 、 C4 、 NBT test 及其營養狀況 albumin 、 prealbumin 並且觀察兩組的消化狀況。研究結果發現兩組之間無論是免疫反應或是營養狀況都無統計差異，但 Alitraq® 組在灌食前的營養狀況 prealbumin 比 IMPAC T-Glutamine® 組灌食前好 (p = 0.028) ，不含魚油的 Alitraq® 組灌食後的營養狀況 prealbumin 比灌食前明顯增加 (p = 0.043) ，且 C3 灌食前比灌食後也有明顯的增加 (p = 0.018) ， IMPACT-Glutamine® 組灌食前與灌食後營養狀況及免疫反應並無明顯的差異， IMPACT-Glutamin e® 組七名病患中灌食後有五名病患嚴重腹瀉，不含魚油的 Alitraq®

組七名病患消化良好無腹瀉的發生。本研究發現含魚油配方 IMPAC T-Glutamine® 無法產生改善病患免疫反應的效果，並產生嚴重的腹瀉現象。

(2)

Immune Responses in Abdominal Surgery Patients Administrated with Enter Immune Enhancing Formula



The proposed study was to assess the effectiveness of enhanced fish oil immune enteral feedin g formula on the immune responses of patients with abdominal surgery. The patients were divi ded into two groups, one group was administrated with fish oil enhanced IMPACT-Glutamine

® (n=7) formula, another group was given the commercial formula Alitraq® without fish oil

(n=7). Two groups were treated with isocalorie (30 kcal/Kg body weight) condition. The APA

CHE II Score of patients were less than 15. The immune responses (i.e., CD4, CD8, CD4/CD8

腸道灌食免疫配方對腹部手術病患免疫反應之影響



Immune Responses in Abdominal Surgery Patients Administrated with Enter Immune Enhancing Formula

The proposed study was to assess the effectiveness of enhanced fish oil immune enteral feedin g formula on the immune responses of patients with abdominal surgery. The patients were divi ded into two groups, one group was administrated with fish oil enhanced IMPACT-Glutamine

® (n=7) formula, another group was given the commercial formula Alitraq® without fish oil

(n=7). Two groups were treated with isocalorie (30 kcal/Kg body weight) condition. The APA

CHE II Score of patients were less than 15. The immune responses (i.e., CD4, CD8, CD4/CD8

, C3, C4, and NBT test), the nutrition status (i.e. albumin, prealbumin), and digestion conditio

n (i.e. frequency of diarrhea) of two groups were evaluated before feeding and fed on day 7, re

spectively. In results, there were no statistical differences before treatment on immune respons

es and albumin except prealbumin in two groups. The prealbumin level of control group was s

ignificant higher than the IMPACT-Glutamine® group (p = 0.028) before treatment. However

after administration, the prealbumin (p = 0.043) and C3 (p = 0.018) were significant higher tha

n before treatment in the Alitraq® group. The IMPACT-Glutamine® group was no significant

differences between before and after administration in immune response and nutrition status. F

ive patients fed with enhanced fish oil formula had serious diarrhea. None of the patients prese

nted diarrhea in Alitraq® group. In conclusion, the IMPACT-Glutamine® fish oil enhanced fo

rmula did not present the postive immune response of patients with abdominal surgery and res

ulted in serious diarrhea.