| ObjectiveEffects of Arginine-Enhanced immunonutrition on postoperative immune function and infection rate in patients with gastric cancer.MethodsPubMed,Cochrane Library,Embase,Web of Science,CNKI,Wanfang database,VIP database and other databases were retrieved to collect all the randomized controlled trials(RCTs)published in 1996 to January 2017,which researched arginine-enhanced immunonutrition applied in patients with gastric cancer who need postoperative nutritional support.And relevant degree papers,meeting minutes and other gray literature was searched through the Internet.We conducted the quality assessment of included literature by the risk of bias table provided on Cochrane Library and the modified Jadad Scale.By two independent reviewers,research data were extracted and evaluated with a designed extraction form,the RevMan 5.2 software was used for Meta-analysis on homogeneous studies.ResultsA total of 241 literatures were retrieved,however,only 13 articles were included in this study,involving 947 cases.Meta analysis results illustrated that perioperative using of arginine-enhanced immune nutrition could reduce the rate of postoperative infection in patients with gastric cancer OR=0.42,95%CI(0.21,0.86),P=0.02,and the difference was statistically significant.Cellular immune function was enhanced simultaneously.CD3 + T cell subsets [MD=4.95,95%CI(3.82,6.08),P<0.00001]? CD4+ T cell subsets [MD=5.38,95%CI(3.02,7.74),P<0.00001]? CD8+ T cell subsets [MD=-1.46,95%CI(-2.53,-0.39),P=0.008]? CD4+/CD8+[MD=0.26,95%CI(0.02,0.50),P=0.03],and the indicators reflect humoral immune function(IgA,IgG,IgM,etc.)in the experimental group were significantly higher than those in the control group,and the differences between the two groups were statistically significant.Conclusion Arginine-enhanced immunonutrition can enhance postoperative immune function in patients with gastric cancer and reduce the incidence of postoperative infectious complications. |
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