Wu Zhengshan, Qin Jianjie, Pu Liyong
Liver Transplantation Center, the First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China; ; Key Laboratory of Living Donor Liver Transplantation, Ministry of Public Health, Nanjing, Jiangsu 210029, China.
J Biomed Res. 2012 Nov;26(6):395-9. doi: 10.7555/JBR.26.20120058. Epub 2012 Oct 23.
Omega-3 fatty acid supplemented total parenteral nutrition improves the clinical outcome of patients undergoing certain operations; however, its benefits for patients with hepatitis type B virus (HBV)-associated hepatocellular carcinoma (HCC) who have undergone hepatectomy are still not clear. The aim of this study was to evaluate the effect of omega-3 fatty acid supplemented total parenteral nutrition on the clinical outcome of patients with HBV-associated HCC who underwent hepatectomy at our institution. A total of 63 patients with HBV-associated HCC who underwent hepatectomy were included in this study. These patients were randomly assigned to receive standard total parenteral nutrition (the control group, n = 31) or omega-3 fatty acid supplemented total parenteral nutrition (the omega-3 fatty acid group, n = 32) for at least 5 d. The study endpoints were the occurrence of infection-related complications, recovery of liver function and length of hospital stay. The results showed that the omega-3 fatty acid group had a lower infection rate (omega-3 fatty acid, 19.4% vs control, 43.8%, P < 0.05), a better liver function after hepatectomy: alanine transaminase (omega-3 fatty acid, 48.23±18.48 U/L vs control, 73.34±40.60 U/L, P < 0.01), aspartate transaminase (omega-3 fatty acid, 35.77±14.56 U/L vs control, 50.53±24.62 U/L, P < 0.01), total bilirubin (omega-3 fatty acid, 24.29±7.40 mmol/L vs control, 28. 37±8.06 mmol/L, P < 0.05) and a shorter length of hospital stay (omega-3 fatty acid, 12.71±2.58 d vs control, 15.91±3.23 d, P < 0.01). The serum contents of IL-6 (omega-3 fatty acid, 23.98±5.63 pg/mL vs control, 35.55±7.5 pg/mL, P < 0.01) and TNF-α (omega-3 fatty acid, 4.43±1.22 pg/mL vs control, 5.96±1.58 pg/mL, P < 0.01) after hepatectomy were significantly lower in the omega-3 fatty acid group than those of the control group. In conclusion, administration of omega-3 fatty acid may reduce infection rate and improve liver function recovery in HBV-associated HCC patients after hepatectomy. This improvement is associated with suppressed production of proinflammatory cytokines in these patients.
补充ω-3脂肪酸的全胃肠外营养可改善接受某些手术患者的临床结局;然而,其对接受肝切除术的乙型肝炎病毒(HBV)相关肝细胞癌(HCC)患者的益处仍不明确。本研究旨在评估补充ω-3脂肪酸的全胃肠外营养对在我院接受肝切除术的HBV相关HCC患者临床结局的影响。本研究共纳入63例接受肝切除术的HBV相关HCC患者。这些患者被随机分配接受标准全胃肠外营养(对照组,n = 31)或补充ω-3脂肪酸的全胃肠外营养(ω-3脂肪酸组,n = 32)至少5天。研究终点为感染相关并发症的发生、肝功能恢复情况及住院时间。结果显示,ω-3脂肪酸组感染率较低(ω-3脂肪酸组为19.4%,对照组为43.8%,P < 0.05),肝切除术后肝功能较好:谷丙转氨酶(ω-3脂肪酸组为48.23±18.48 U/L,对照组为73.34±40.60 U/L,P < 0.01)、谷草转氨酶(ω-3脂肪酸组为35.77±14.56 U/L,对照组为50.53±24.62 U/L,P < 0.01)、总胆红素(ω-3脂肪酸组为24.29±7.40 mmol/L,对照组为28.37±8.06 mmol/L,P < 0.05),住院时间较短(ω-3脂肪酸组为12.71±2.58天,对照组为15.91±3.23天,P < 0.01)。肝切除术后,ω-3脂肪酸组的血清IL-6含量(ω-3脂肪酸组为23.98±5.63 pg/mL,对照组为35.55±7.5 pg/mL,P < 0.01)和TNF-α含量(ω-3脂肪酸组为4.43±1.22 pg/mL,对照组为5.96±1.58 pg/mL,P < 0.01)明显低于对照组。总之,给予ω-3脂肪酸可能降低HBV相关HCC患者肝切除术后的感染率并改善肝功能恢复。这种改善与这些患者促炎细胞因子产生的抑制有关。