肝移植后炎症因子谱改变及ω-3鱼油脂肪乳的影响  

Effects of omega-3 fish oil emulsion on changes in serum cytokines after liver transplantation

作　　者：江涛[1] 王轩[1] 杨爱珍[1] 陆雷[1] 张冬华[1] 张荣生[1] 

机构地区：[1]解放军第81医院南京军区肝移植中心,江苏省南京市210002

出　　处：《中国组织工程研究与临床康复》2011年第31期5726-5730,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：南京军区面上项目(08MA050)~~

摘　　要：背景:ω-3鱼油脂肪乳可改变肝移植后机体的炎症状态。目的:观察ω-3鱼油脂肪乳对肝移植后炎症因子谱及预后的影响。方法:将36例同种异体原位肝移植患者前瞻性随机分为实验组和对照组。两组移植后给予等氮等热量的营养支持和相同的免疫抑制方案,实验组移植后第2天在中长链脂肪乳中添加ω-3鱼油脂肪乳,连用6d;对照组中长链脂肪乳中未添加。结果与结论:与对照组比较,实验组移植后第5,8天白细胞介素1β、白细胞介素2、白细胞介素6、肿瘤坏死因子α、前列腺素E2和白三烯B4等不同程度下调;白细胞介素4、白细胞介素10、转化生长因子β和白三烯B5等不同程度上调;移植后第8天白细胞介素6/白细胞介素10显著下降,白细胞介素10/肿瘤坏死因子α升高(P<0.01)。两组围手术期死亡率和急性排斥反应发生率差异无显著性意义,但实验组重症监护时间和住院时间显著短于对照组(P<0.05)。说明肝移植后添加ω-3鱼油脂肪乳可调整促炎/抗炎因子平衡,纠正过度炎症反应,改善预后。BACKGROUND：Omega-3 fish oil emulsion can adjust systemic inflammatory response after liver transplantation. OBJECTIVE：To investigate the effects of omega-3 fish oil emulsion on the changes of cytokines and the prognosis of patients undergoing liver transplantation. METHODS：All 36 orthotopic liver transplantation patients were prospectively randomized into two groups：experimental and control. After liver transplantation, two group patients received isocaloric and isonitrogenous nutritional support and the same immunosuppressive regimen. From day 2 after liver transplantation, the experimental group patients received omega-3 fish oil emulsion for successive 6 days while the control group patients did not. RESULTS AND CONCLUSION： Compared with the control group, on days 5, 8 after liver transplantation, interleukin （IL）-1β,IL-2, IL-6, tumor necrosis factor （TNF）-α, prostaglandin E2, and leucotriene B4 were downregulated to different degrees, IL-4, IL-10, TNF-β and leukotriene were upregulated to different degrees in the experimental group. On day 8 after liver transplantation, the ratio of IL-6/IL-10 was significantly decreased and the ratio of IL-10/ TNF-α was significantly increased （P 0.01）.There was no significant difference in perioperative mortality and acute rejection incidence between experimental and control groups. However, The postoperative ICU stay time and hospital stay time were significantly shorter in the experimental group than in the control group （P 0.05）. These results showed that additional omega-3 fish oil emulsion in liver transplantation patients can effectively decline the levels of proinflammatory cytokines and retrieve the extra inflammatory response, modulate the balance of pro-/anti-inflammation,and improve prognosis.

关 键 词：鱼油 肝移植 炎症 细胞因子 炎症因子 

分 类 号：R617[医药卫生—外科学]