n-3脂肪酸对外科术后SIRS患者阻断过度炎症反应作用.docVIP

n-3脂肪酸对外科术后SIRS患者阻断过度炎症反应作用 　　033100山西方山县人民医院【sup】1【/sup】 　　030001山西医科大学第一附属医院【sup】2【/sup】 　　摘 要 目的：探讨n-3脂肪酸对外科全身炎症反应综合征（SIRS）患者阻断过度炎症反应的作用。方法：将符合SIRS诊断标准的48例外科术后危重症患者随机分为实验组（24例）和对照组（24例）。两组患者都给予全肠外营养（TPN）连续五天，实验组TPN加入n-3鱼油脂肪乳剂100ml，而对照组不加。分别于TPN前1天和后第5天抽取外周静脉血，测量炎症反应指标：C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白介素-1（IL-1）、白介素-6（IL-6）、白介素-8（IL-8）。结果：两组炎症反应指标研究结束时与治疗前比较均有回落（P＜0.05），但实验组较对照组降低明显，差异有统计学意义（P＜0.05）。结论：n-3脂肪酸对外科术后SIRS患者在阻断过度炎症反应方面发挥了重要的作用，改善了SIRS患者的预后，为SIRS的治疗提供一种新的方法和思路。 　　关键词 n-3脂肪酸 全肠外营养 全身炎症反应综合征 　　doi:10.3969/j.issn.1007-614x.2011.04.038 　　AbstractObjective:To evaluate the effect of n-3 fatty acids on anti-inflammatory responses in the surgical postoperative patients with systemic inflammatory response syndrome （SIRS）.Methods:Forty-eight cases surgical postoperative patients with SIRS were divided into n-3 fatty acids group and control group.All patients were treated with TPN.Twenty-four cases in n-3 fatty acids group were treated with n-3 fatty acids supplied by n-3 fatty acids solution 100ml,and the other twenty-four cases in control group were not given.All patients were observed for 5 days.The data about inflammatory parameter were measured and analyzed,respectively,1 day before TPN and 5 days after TPN.And the acute physiology has also been respectively assessed.Results:No side effects were noted.The scores of acute physiology the level of serum CRP,IL-1,IL-6,IL-8,TNF-α decreased significantly in two groups （P＜0.05）,but the decrease in n-3 fatty acids group was more obvious than that in control group （P＜0.05）.Conclusion:N-3 fatty acids could relieve the degree of acute inflammatory response of the surgical postoperative patients with SIRS,and benefit to resume the function of cells and organs. 　　Key Words n-3 fatty acids；TPN；SIRS 　???资料与方法 　　所有病例均来源于山西医科大学附属一院2009年8～11月，普外科住院术后危重症患者。将符合SIRS诊断标准：1992年美国胸内科医师学会和危重症医学会联席会议制定【sup】［1］【/sup】：①体温＞38℃或＜36℃；②心率＞90次/分；③呼吸＞20次/分或PaCO【sub】2【/sub】＜32mmHg；④WBC＞12×10【sup】9【/sup】/L或＜4.0×10【sup】9【/sup】/L或幼稚白细胞＞10%，具