摘要
目的探讨多发伤后细胞免疫功能的变化及加鱼油肠外营养对多发伤患者的影响。方法2007年8月至2008年3月本中心收治的26例多发伤患者随机分为鱼油组和常规组,入院后即按等氮等热量的肠外营养方式给药:常规组脂肪采用大豆油1.2 g.kg-1.d-1,鱼油组脂肪采用大豆油1.0 g.kg-1.d-1加鱼油0.2 g.kg-1.d-1,均连续使用5 d。于入院后及治疗后第3、6天采集患者外周静脉血,ELISA法检测CRP、MIF、IFN-γ及IL-4浓度。结果多发伤患者外周血中CRP、MIF、IL-4水平均较对照组升高非常显著(P<0.01),IFN-γ水平较对照组降低非常显著(P<0.01);治疗后第3天,鱼油组CRP、IL-4水平较常规组显著降低(P<0.05),MIF水平较常规组降低非常显著(P<0.01),IFN-γ水平较常规组显著升高(P<0.05);治疗后第6天,鱼油组CRP、IL-4水平均较常规组降低非常显著(P<0.01),IFN-γ水平较常规组升高非常显著(P<0.01)。结论常规治疗的同时,补充ω-3 PUFAs可以显著改善多发伤患者机体免疫防御,有效抑制了Th1/Th2应答模式的偏移,降低了多发伤后过度的炎症反应程度,对提高多发伤患者的救治具有重要意义。
Objective To observe the changes of cellular immune function on multiple trauma patients and the effects of fish oil parenteral nutrition on these changes. Methods Totally 26 patients of multiple trauma were randomly and equally divided into fish oil group （mainly containing ω-3 polyunsaturated fatty acids） and conventional group. Another 20 health individuals served as control. Besides regular management, conventional group was given parenteral nutrition with soybean oil 1.2 g·kg^-1·d^-1, fish oil group with soybean oil 1.0g·kg^-1·d^-1 and fish oil 0.2 g·kg^-1·d^-1 for 5 d. Collection of peripheral blood before treatment and 3 and 6 d after treatment respectively. Serum concentration of C-reactive protein （ CRP）, macrophage migration inhibitory factor （MIF）, IFN-γand IL-4 were measured with ELISA. Results Serum concentration of CRP, MIF and IL-4 levels were significantly higher in multiple trauma patients than the control group （ P 〈 0. 01 ）, IFN-γ level was significantly lower （P 〈0.01 ）. From t the 3rd day after treatment, the fish oil group had sig- nificantly lower levels of CRP and IL-4 （P 〈 0. 05 ） , and very significantly lower MIF than the conventional group （P 〈0.01 ）, while that of IFN-γ level was significantly higher in the former than the later group （P 〈 0. 05） ; at the 6th day after treatment, the CRP, MIF, IL-4 levels of fish oil group was very significant lower than the conventional group （P 〈 0.01 ）, and IFN-γ level very significant higher（ P 〈 0.01 ）. Conclusion ω-3 polyunsaturated fatty acids can be regarded a helpful supplementation for regular management for multiple trauma, which significantly improves immune defense by effectively suppressing the Th1/Th2 response patterns shift and reducing secondary injuries after excessive inflammatory response.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2009年第5期446-449,共4页
Journal of Third Military Medical University
关键词
ω-3多聚不饱和脂肪酸
肠外营养
多发伤
C-反应蛋白
移动抑制因子
干扰素-Γ
白介素4
ω-3 polyunsaturated fatty acids
parentcral nutrition
multiple trauma
C-reactive protein
macrophage migration inhibitory factor
interferon-γ
interleukin4
