目的探讨新辅助化疗（NAC）联合营养治疗在原发性肺癌患者中的应用效果。方法选择88例确诊为原发性肺癌患者作为研究对象，所有患者均给予NAC治疗，采用随机数字法平均分为观察组与对照组，对照组给予常规普通饮食，观察组给予营养治疗。比较NAC前、治疗4个疗程后患者营养状况（包括总蛋白、白蛋白及前白蛋白）、肺功能及T细胞亚群差异。结果NAC后对照组营养指标水平均低于NAC前，差异有统计学意义（P<0.05）；NAC后观察组营养指标均高于对照组（P<0.05）。NAC后对照组第1秒用力呼气容积（FEV1）、最大自主通气量（MVV）、V/Q及RV/TCL均低于NAC前（P<0.05）；NAC后观察组V/Q及RV/TCL低于NAC前（P<0.05）；NAC后观察组FEV1、MVV及V/Q均高于对照组（P<0.05）；NAC后观察组RV/TCL低于对照组（P<0.05）。NAC后观察组CD4+T细胞/CD8+T细胞低于NAC前（P<0.05）；NAC后对照组CD4+T细胞、CD4+T细胞/CD8+T细胞均低于NAC前（P<0.05）；NAC后观察组CD4+T细胞、CD4+T细胞/CD8+T细胞均高于对照组（P<0.05）。结论营养治疗可以明显改善原发性肺癌患者NAC治疗引起的营养状况下降，同时降低化疗药物引起的肺功能损伤，并保证患者有较好的免疫功能。
Objective To explore the effect of neoadjuvant chemotherapy (NAC) combined with nutritional support in patients with primary lung cancer, and to provide a reference for its clinical research. Methods Eighty-eight patients diagnosed with primary lung cancer were selected as the research subjects. All patients were treated with NAC. They were divided equally into observation group and control group by random number method. The control group was given conventional diet and the observation group was given nutrition support treatment. The differences in nutritional status (including total protein, albumin, and prealbumin), lung function, and T cell subsets were compared before NAC and after 4 courses of treatment. Results After NAC, the nutrition index level of the control group was lower than that before NAC, and the difference was statistically significant (P<0.05)；the nutrition index of the observation group after NAC was higher than that of the control group (P<0.05). After NAC, FEV1, MVV, V/Q, and RV/TCL in the control group were lower than before NAC (P<0.05)；V/Q and RV/TCL in the observation group after NAC were lower than before NAC (P<0.05)；The FEV1, MVV and V/Q of the group were higher than those of the control group (P<0.05)；the RV/TCL of the observation group after NAC was lower than that of the control group (P<0.05). CD4+/CD8+in the observation group after NAC was lower than before NAC (P<0.05)；CD4+, CD4+/CD8+in the control group after NAC were lower than before NAC (P<0.05)；CD4+, CD4+/CD8+in the observation group after NAC were higher than the control Group (P<0.05). Conclusion Nutritional support can significantly improve the nutritional decline caused by NAC treatment in patients with primary lung cancer, reduce lung function damage caused by chemotherapeutic drugs, and ensure that patients have better immune function, which is worthy of clinical application.
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