鱼油脂肪乳对胃肠道急诊手术病人机体免疫及炎性反应的影响.docVIP

鱼油脂肪乳对胃肠道急诊手术病人机体免疫及炎性反应的影响 王浩，席时富 （南京大学医学院附属鼓楼医院胃肠外科，江苏南京210008） 摘要： 目的：探讨ω-3多不饱和脂肪酸对胃肠道急诊手术病人的免疫调节和抗炎作用。方法：将2010年1月~12月行胃肠道急诊手术的病人64例，分为研究组和对照组，术后研究组每日补充鱼油。于治疗前和治疗后第7天检测 C反应蛋白( CRP)、肿瘤坏死因子α( TNF-α)、IL-6、T细胞亚群( CD3、CD4、CD8)。结果：术后第7日，研究组病人血清 CRP、TNF-α、IL-6均显著低于对照组，研究组CD3、CD4、CD4/CD8值显著高于对照组。结论：应用ω-3多不饱和脂肪酸可使胃肠道急诊手术病人血清炎性介质表达减少，改善机体免疫功能。 关键词：ω-3多不饱和脂肪酸；鱼油脂肪乳；胃肠道急诊手术 Influence of ω-3 PUFA on immunity of patients after emergent gastrointestinal surgery WANG Hao， XI Shi-fu （Department of General Surgery,Nanjing Drum Tower Hospital,Medical College of Nanjing University, Nanjing Jiangsu 210008, China） Abstract: Objective: To investigate the effect of ω-3 PUFA on patients after emergent gastrointestinal operation through immune regulation and anti -inflammatory response. Methods: Sixty-four patients who underwent emergent gastrointestinal operation in our hospital between January，2010 to December，2010 were divided into two groups: study group and control group. During the first day after surgery to the sequent seven days,Fish-oil fatty emulsion was given to the study group each day. The serum concentrations of inflammatory response indicators and cell-mediated immunology function were measured. Results: Compared with the patients in control group, patients treated with Fish-oil fatty emulsion had significantly lower CRP、TNF-α、IL-6 concentration and higher CD3、CD4、CD4/CD8 level at postoperative day seven. Conclusions: The application of ω-3 PUFA can suppress inflammatory reaction in patients after emergent gastrointestinal operation and improve immunity. Key words: ω-3 PUFA; Fish oil emulsion; emergent gastrointestinal operation 0　引　　言 行胃肠道急诊手术的病人由于感染和创伤等因素，术后常有较重的腹腔感染和炎性反应，严重者甚至发生全身炎症反应综合征 ( SIRS)、成人呼吸窘迫综合征(ARDS)等危重症。近年来，有大量文献报道，ω-3鱼油脂肪乳有调节病人免疫功能、减轻过度炎症反应的作用[1，2 ]。为此，我们将ω-3鱼油脂肪乳应用于胃肠道急诊手术后病人，观察其对炎症反应、机体免疫功能的影响。 临床资料及方法 1.1一般资料 将2010年01～12月南京大学医学院附属鼓楼医院普外科64例胃肠道急诊手术病人术后随机分为研究组和对照组，年龄 17～84岁，每组各 32例。两组病人在性别、 年龄、 疾病种类、手术方式、手术时间及出血量等方面均无显著性差异(表 1)。术前发现有肝肾功能严重不全、高脂血症、糖尿病、出凝血时间