ω-3多不饱和脂肪酸对AECOPD机械通气患者肺保护研究  

The study on the lung protective effect of omega-3 polyunsaturated fatty acids in patients with acute exacerbations of chronic obstructive pulmonary disease using mechanical ventilation

作　　者：林孟相[1] 孔万权[1] 魏大臻[1] 庄荣[1] 金盛威[1] 

机构地区：[1]温州医学院附属第二医院ICU,浙江温州325027

出　　处：《中国现代医生》2013年第4期46-47,50,共3页China Modern Doctor

基　　金：浙江省温州市2010年第四期科技计划项目(Y20100266)

摘　　要：目的观察AECOPD机械通气患者应用ω-3多不饱和脂肪酸(PUFA)脂肪乳治疗后,对肺的保护作用。方法将46例AECOPD机械通气患者按区组随机化,分为对照组和研究组,每组各23例,两组患者均接受等氮、等热量的全胃肠外营养,其中研究组加用ω-3多不饱和脂肪酸[(0.2 g/(kg.d)],共10 d;检测入ICU前和治疗后第1、3、7天患者血清白细胞介素6(IL-6)、IL-8、肿瘤坏死因子(TNF-α)水平,并观察记录动脉血气结果及机械通气时间。结果①研究组治疗前及后第1天IL-6、IL-8、TNF-α水平较对照组无明显变化(P>0.05);余时间点研究组均明显低于对照组(P均<0.05);②经机械通气治疗后,两组患者动脉血氧分压、二氧化碳水平较前均有改善,研究组改善尤为明显,且机械通气时间明显短于对照组,差异均有统计学意义(P均<0.05)。结论血清白细胞介素6(IL-6)、IL-8、肿瘤坏死因子(TNF-α)参与了AECOPD患者的全身炎症反应,ω-3多不饱和脂肪酸可降低IL-6、IL-8、TNF-α水平,有利于患者呼吸功能改善,可以缩短机械通气时间。Objective To evaluate the lung protective effect of -3 PUFA in AECOPD using mechanical ventilation. Methods A total of 46 AECOPD patients using mechanical ventilation were randomly divided into control group and treatment group, each with 23 patients. Both group intake the equally same parentaralnutrition;Besides,treatment group intake 7d -3 PUFA more. The level of serum interleukin-6 （IL-6）, IL-8 and TNF-α level were detected both before ICU and on the 1st ,3th,Tth d after the treatment,The changes of patients＇ ABG results and time of mechani cal ventilation were also observed. Results （ 1 ）The IL-6, IL-8 and TNF-α level has no difference on before treatment and the 1st day （P 〉 0.5） ,it is significantly lower in treatment group than in control group on the other days. （2）Both groups showed improvement in PaO2 and CO2 level, and treatment group patients are particularly obvious,and shorten the time of mechanical ventilation （P 〈 0.05）. Conclusion The serum interleukin-6 （IL-6）, IL-8 and TNF-α all take part inthe systemic inflammation of AECOPD patient, ω-3 PUFA can decrease the level of IL-6, IL-8 and TNF-α, is beneficial to the recovery of the patients＇ respiratory and shorten the time of mechanical ventilation.

关 键 词：AECOPD 机械通气 Ω-3多不饱和脂肪酸 IL-6 IL-8 TNF-α 

分 类 号：R442.8[医药卫生—诊断学]