ω-3多不饱和脂肪酸对急性呼吸窘迫综合征患者血清炎症介质的影响  

Effect of omega-3 polyunsaturated fatty acids on inflammatory mediators in patients with acute respiratory distress syndrome

作　　者：孔万权[1] 王征[1] 夏轶姿[1] 齐艳红[1] 孙来芳[1] 龚裕强[1] 

机构地区：[1]温州医学院附属第二医院急诊ICU,325027

出　　处：《中华危重症医学杂志（电子版）》2012年第1期11-14,共4页Chinese Journal of Critical Care Medicine:Electronic Edition

基　　金：温州市科技计划项目(Y20100266)

摘　　要：目的观察ω-3多不饱和脂肪酸对急性呼吸窘迫综合征(ARDS)患者血清炎症介质释放的影响。方法将42例ARDS患者按随机化数字表原则,分为对照组和研究组,每组各21例。两组患者均接受等氮、等热量的全胃肠外营养,热量25kcal·kg-1·d-1、氮摄入量0.2g/kg,其中研究组加用ω-3多不饱和脂肪酸(0.2g·kg-·1d-1),共7d。分别检测治疗前和治疗后第1、3、7天血清白细胞介素1(IL-1)、IL-6、肿瘤坏死因子α(TNF-α)水平,并观察动脉血氧分压和氧合指数的变化。结果加用ω-3多不饱和脂肪酸治疗后,研究组在不同时间点IL-1、IL-6、TNF-α均明显低于对照组(P均<0.05);两组患者动脉血氧分压和氧合指数均有改善,且研究组氧合指数较高,差异均有统计学意义(P均<0.05)。结论ω-3多不饱和脂肪酸可降低ARDS患者IL-1、IL-6、TNF-α水平,在一定程度上有利于ARDS患者呼吸功能的恢复。Objective To investigate the effect of omega-3 polyunsaturated fatty acids on the release of serum inflammatory mediators in patients with acute respiratory distress syndrome（ARDS）. Methods Forty-two patients with ARDS were randomly divided into control and research groups, 21 in each. All the patients were given total parenteral nutrition including equal nitrogen （0.2 g / kg） and calorie （25 kcal·kg^-1·d^-1）, while in the research group patients are given extra omega-3 polyunsaturated fatty acids （0.2 g·kg^-1·d^-1） for 7 d. The levels of serum interleukin-1 （IL-1）, IL-6 and tumor necrosis factor-alpha （TNF-α） were detected both before treatment and on the 1st, 3th, 7th d after the treatment, respectively. The changes of arterial partial pressure of oxygen and oxygenation index were also observed. Results The levels of IL-1, IL-6 and TNF-α in the research group were all significantly lower than the control group at different time points （all P〈0.05）. After the treatment, the arterial partial pressure of oxygen and oxygenation index in the two groups were all improved, and in the research group oxygenation index were much higher （all P〈0.05）. Conclusion Omega-3 polyunsaturated fatty acids can reduce the expression of IL-1, IL-6 and TNF-α, which to a certain extent, is beneficial to the recovery of respiratory function in patients with ARDS.

关 键 词：脂肪酸类 ω3 呼吸窘迫综合征 成人 白细胞介素类 肿瘤坏死因子α 

分 类 号：R563.8[医药卫生—呼吸系统]