ω-3鱼油脂肪乳对重症急性胰腺炎患者炎症免疫反应及器官功能的影响

[The effects of ω-3 fish oil lipid emulsion on inflammation-immune response and organ function in patients with severe acute pancreatitis].

作者信息

Xu Qiang-hong, Cai Guo-long, Lü Xiao-chun, Hu Cai-bao, Chen Jin, Yan Jing

机构信息

Department of Intensive Care Unit, Zhejiang Hospital, Hangzhou, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2012 Dec;51(12):962-5.

PMID:23327958

Abstract

OBJECTIVE

To investigate the effects of ω-3 fish oil lipid emulsion via vein on the inflammatory response, immune and organ function in patients with severe acute pancreatitis.

METHODS

A total of 53 patients with severe acute pancreatitis were randomized into conventional therapy plus fish oil group (FO group) and conventional therapy group (CON group). The patients in FO group were treat with ω-3 fish oil lipid emulsion (0.2 g×kg(-1)×d(-1), 10%) based on conventional therapy for 14 days. The level of C-reactive protein (CRP), TG and TC were detected before treatment and at day 7 and day 14 after treatment. CD(4)(+), CD(4)(+)/CD(8)(+) and C(3), C(4) were also detected at day 1 and day 14 after treatment. At the same time, acute physiology and chronic health evaluation II score (APACHEII score), intra-abdominal pressure, negative fluid balance time, enteral nutrition start-time and ICU stay time were observed and recorded.

RESULTS

Forty-five out of 53 patients were finally recruited into results statistics. The level of CD(4)(+), CD(4)(+)/CD(8)(+) and C(3) at day 14 after treatment in FO groups improved significantly than that in the CON group (P < 0.05). The levels of CRP, intra-abdominal pressure and APACHE II score at day 7 and day 14 in FO group descended more obviously than that in the CON group (P < 0.05). The negative liquid balance time in FO group (3.55 ± 0.86)days was obvious shorter than that in CON group (4.61 ± 1.12) days, while enteral nutrition start-time (3.86 ± 1.17) days was significantly earlier compared with CON group (5.30 ± 1.61) days (P < 0.05), however ICU stay time and 28 days mortality rate had no significant difference between the two groups.

CONCLUSIONS

ω-3 fish oil lipid emulsion can decrease the inflammatory response and the negative liquid balance time, improve the immune function and restore bowel function in severe acute pancreatitis patients. Therefore, it maybe provide a new and effective means for severe acute pancreatitis.

摘要

目的

探讨静脉输注ω-3鱼油脂肪乳剂对重症急性胰腺炎患者炎症反应、免疫及器官功能的影响。

方法

将53例重症急性胰腺炎患者随机分为常规治疗加鱼油组（FO组）和常规治疗组（CON组）。FO组患者在常规治疗基础上给予ω-3鱼油脂肪乳剂（0.2 g×kg⁻¹×d⁻¹，10%）治疗14天。于治疗前及治疗后第7天、第14天检测C反应蛋白（CRP）、甘油三酯（TG）及总胆固醇（TC）水平。于治疗后第1天和第14天检测CD4⁺、CD4⁺/CD8⁺及补体C3、C4水平。同时观察并记录急性生理与慢性健康状况评分系统II（APACHEII评分）、腹内压、负液体平衡时间、肠内营养开始时间及重症监护病房（ICU）住院时间。

结果

53例患者中45例最终纳入结果统计。FO组治疗后第14天CD4⁺、CD4⁺/CD8⁺及C3水平较CON组显著改善（P<0.05）。FO组治疗后第7天和第14天CRP水平、腹内压及APACHE II评分下降较CON组更明显（P<0.05）。FO组负液体平衡时间（3.55±0.86）天明显短于CON组（4.61±1.12）天，肠内营养开始时间（3.86±1.17）天较CON组（5.30±1.61）天显著提前（P<0.05），但两组ICU住院时间及28天死亡率无显著差异。