Martínez-Ordaz José Luis, Boscó-Gárate Ilka, Cérbulo-Vázquez Arturo, Arriaga-Pizano Lourdes, Wong-Baeza Isabel, Sánchez-Fernandez Patricio, López-Macías Constantino, Isibasi Armando, Ferat-Osorio Eduardo
Servicio de Gastrocirugía, UMAE Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México.
Unidad de Investigación Médica en Inmunoquímica, UMAE Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Avenida Cuauhtémoc 330, Colonia Doctores, CP 06720, Ciudad de México, México.
J Gastrointest Surg. 2017 Mar;21(3):453-462. doi: 10.1007/s11605-016-3333-6. Epub 2016 Dec 1.
The presence of digestive fistula involves chronic inflammation and fibrosis. It has been reported that ω3-polyunsaturated fatty acids stimulate the resolution of inflammation.
Determine if the administration of oral ω3 reduces fistula output and the time required for fistula closure.
Forty-nine patients with postoperative fistula were randomly divided in two groups: 26 received conventional treatment and 23 received the conventional treatment supplemented with ω3 (540 mg eicosapentaenoic acid and 360 mg docosahexaenoic acid) for 35 days. Patients were monitored daily for fistula output and spontaneous closure. Additionally, serum pro-inflammatory cytokines and C-reactive protein were quantified in four patients with conventional and in seven patients with ω3 treatment.
Patients with ω3 had significantly decreased fistula output from days 2 to 27, compared to control (p < 0.05). Spontaneous fistula closure was achieved in 15 patients (65%) in the ω3 group and in 14 (54%) in the control group. ω3-polyunsaturated fatty intake also decreased the serum concentrations of interleukin-6 and C-reactive protein (p < 0.05).
Our results suggest that ω3 supplementation to conventional medical treatment decreases fistula output and reduces inflammation (interleukin-6 and C-reactive protein), and these effects may increase the efficiency of conventional medical treatment.
消化瘘的存在涉及慢性炎症和纤维化。据报道，ω3多不饱和脂肪酸可促进炎症消退。
确定口服ω3是否能减少瘘管排出量以及瘘管闭合所需时间。
49例术后瘘患者随机分为两组：26例接受传统治疗，23例在传统治疗基础上加用ω3（540毫克二十碳五烯酸和360毫克二十二碳六烯酸），为期35天。每天监测患者的瘘管排出量和自发闭合情况。此外，对4例接受传统治疗的患者和7例接受ω3治疗的患者的血清促炎细胞因子和C反应蛋白进行定量分析。
与对照组相比，ω3组患者在第2天至27天的瘘管排出量显著减少（p < 0.05）。ω3组15例患者（65%）实现了瘘管自发闭合，对照组为14例（54%）。摄入ω3多不饱和脂肪酸还降低了白细胞介素-6和C反应蛋白的血清浓度（p < 0.05）。
我们的结果表明，在传统药物治疗基础上加用ω3可减少瘘管排出量并减轻炎症（白细胞介素-6和C反应蛋白），这些作用可能会提高传统药物治疗的效果。
