摘要
目的:观察含有不同ω-3/ω-6比例脂肪酸的PN,能否改变重症急性胰腺炎(SAP)病人血脂肪酸谱,进而改善机体早期炎性反应和器官功能。方法:40例SAP病人随机分为研究组和对照组,每组20例。使用等氮、等热量PN,共5 d,其中非蛋白质热量117 kJ(28 kcal)/(kg.d)、氮量0.2 g/(kg.d)。对照组用中长链脂肪乳剂,研究组用添加ω-3多不饱和脂肪酸的中长链脂肪乳剂,分别在试验前和试验第6天早晨抽取静脉血,检测血游离脂肪酸谱、IL-6、WBC、C反应蛋白(CRP)等,同时记录生命体征和肺、肾等器官功能指标。结果:研究组CRP水平明显降低,氧合指数得到改善,IL-6有所下降。另外,还观察到研究组病人全身炎性反应综合征(SIRS)比率、急性呼吸窘迫综合征(ARDS)患病率以及合并急性肾功能衰竭病人行连续性血液净化(CBP)时间均有所下降。结论:添加ω-3多不饱和脂肪酸的PN,能降低SAP病人机体早期炎症反应,改善肺功能,缩短CBP时间。
Objective： To investigate whether ω-3 fatty acid supplementation affects inflammatory response and systemic disease sequelae in severe acute pancreatitis patients. Methods： Forty severe acute pancreatitis patients were prospectively enrolled and were randomly assigned to receive total parenteral nutrition （TPN） for 5 days in a double-blinded manner with either soybean oil （SO） or fish oil （FO） supplementation. Serum concentrations of EPA,IL-6,C reactive protein and white blood cell were measured before TPN and on the sixth day after starting TPN. The vital signs during the TPN infusion were recorded. Routine respiratory and renal parameters were monitored to assess the systemic response at the organ level. Results： Patients treated with ω-3 FA had significantly higher EPA concentration, lower CRP level and better oxygenation index during the observation period. The level of IL-6 was decreased on the sixth day after TPN in the study group. Although there was no significant difference between two groups, the ratio of infection, length of ICU and hospital day had a trend to decrease in the study group. Conclusion： TPN supplemented with ω-3 FA diminishes inflammatory response and systemic disease sequelae in SAP patients. This together with improved respiratory and renal function suggests that the systemic response to pancreatic injury is attenuated.
出处
《肠外与肠内营养》
CAS
2008年第4期214-217,共4页
Parenteral & Enteral Nutrition
基金
国家自然科学基金项目资助(30500404)
