ω-3脂肪酸对肝部分切除术后患者炎症反应和免疫功能的影响  

Effects of ω-3 fatty acids on inflammatory reaction and immunologic function of patients after hepatectomy

作　　者：王云玲[1] 曹景玉[1] 吴力群[1] 刘加秀[1] 

机构地区：[1]青岛大学医学院附属医院肝胆外科,266003

出　　处：《中华临床营养杂志》2011年第3期162-166,共5页Chinese Journal of Clinical Nutrition

摘　　要：目的探讨ω-3脂肪酸对肝部分切除术后患者炎症反应和免疫功能的影响。方法肝部分切除患者82例参加本研究，所有患者按随机数表法随机分为两组，术后给予等热量、等氮肠外营养治疗。对照组单纯使用中长链脂肪乳，研究组使用中长链脂肪乳联合ω-3脂肪酸。分别于术前、术后第1、3、7天抽取空腹静脉血，检测肝功能（总蛋白、白蛋白、前白蛋白、谷丙转氨酶、谷草转氨酶）、凝血功能（国际标准化比值）、免疫球蛋白（IgA、IgG、IgM）、CD3、CD4／CD8及外周血白细胞计数等。结果术后第7天研究组患者血清总蛋白（61，40±5．12）g／L显著高于对照组（58．54±5．53）g/L（P=0．018），研究组谷草转氨酶（32．37±11．92）U／L显著低于对照组（42．50±29．97）U／L（P=0．048），研究组IgA（2．67±1．01）g/L显著高于对照组（2．15±0．77）g/L（P=0．027），研究组IL-1β（7．88±6．45）pg／na显著低于对照组（12．98±11．07）pg／ml（P=0．034），研究组IL-2（24．98±20．38）pg／ml显著低于对照组（43．09±20．74）pg／ml（P=0．002）。两组患者术后第7天外周血白细胞及凝血功能指标差异无统计学意义。结论ω-3脂肪酸有助于改善肝部分切除术后患者免疫功能及肝功能，降低炎症反应。Objective To investigate the effects of ω-3 fatty acids （FA） on inflammatory reaction and immunologic function of patients after hepatectomy. Methods Totally 82 patients were randomized into control group and ω-3 FA group. Both groups received parenteral nutrition （PN） with equal nitrogen and calories. Patients in the control group received medium and long-chain lipid emulsion, and those in the ω-3 FA group received ω-3 FA combined with medium and long-chain lipid emulsion. Liver function test （ serum total protein, prealbumin, albumin, aspartate aminotransferase, alanine aminotransferase）, blood coagulation function （ international normalized ratio）, immune globubin （IgA, lgG, and IgM）, CD3 and CIM/CD8 were measured on the first, third, and seventh post-operative day. Results Serum total protein in the ω-3 FA group [ （61.40 ＋5.12） g/L] was significantly higher than in the control group [ （ 58.54 ± 5.53 ） g/L] （ P = 0.018 ）. Aspartate aminotransferase in the ω-3 FA group [ （32. 37 ±11.92） U/L] was significantly lower than in the control group [ （42. 50 ±29.97）U/L] （P =0. 048）. IgA in the ω-3 FA group [ （2.67 ± 1.01 ） g/L] was significantly higher than in the control group [ （2. 15±0. 77） g/L] （P =0. 027）. IL-113 in the ω-3 FA group [ （7.88 ±6.45） pg/ml] was significantly lower than in the control group [ （ 12.98 ± 11.07） pg/ml] （P = 0. 034）. IL-2 in theω-3 FA group [ （24. 98 ± 20.38 ） pg/ml] was significantly lower than the control group [ （43.09± 20.74 ） pg/ml ] （ P = 0. 002 ）. The white blood cell counts and coagulation function were not significantly different between two groups. ConclusionTotal PN containing ω-3 FA can effectively improve immunologic function and liver function of patients after hepatectomy.

关 键 词：Ω-3脂肪酸 肝切除术 炎症反应 免疫功能 

分 类 号：R657.3[医药卫生—外科学]