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
中文摘要
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 IMPACT-
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-Glutamine®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
IMPACT-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。
英文摘要
The proposed study was to assess the effectiveness of enhanced fish oil immune enteral feeding formula on the immune responses of patients with abdominal surgery.
The patients were divided 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 APACHE 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 condition (i.e.
frequency of diarrhea) of two groups were evaluated before feeding and fed on day 7, respectively. In results, there were no statistical differences before treatment on immune responses and albumin except prealbumin in two groups. The prealbumin level of control group was significant 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 than 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. Five patients
fed with enhanced fish oil formula had serious diarrhea. None of the patients
presented diarrhea in Alitraq® group. In conclusion, the IMPACT-Glutamine® fish oil enhanced formula did not present the postive immune response of patients with abdominal surgery and resulted in serious diarrhea.
