含橄榄油的新型脂肪乳剂对危重症病人免疫功能和炎性反应的影响  

Effects of olive oil based lipid emulsion on immune function and inflammatory reaction in critically ill patients

作　　者：许东琳[1] 汤丽萍[2] 周锦扬[3] 苏伟[1] 傅永鸿[1] 杨自力[1] 

机构地区：[1]广州市第一人民医院重症监护科,广东广州510180 [2]广州市第一人民医院药剂科,广东广州510180 [3]广州市第一人民医院营养科,广东广州510180

出　　处：《肠外与肠内营养》2014年第5期278-281,共4页Parenteral & Enteral Nutrition

摘　　要：目的:通过对危重症病人分别应用含有橄榄油的新型脂肪乳与传统的中/长链脂肪乳,比较两种脂肪乳剂对病人免疫功能和炎性反应的影响。方法:将50例入住ICU行肠外营养(PN)支持7 d以上的危重症病人(APACHEⅡ评分>12分),按前瞻、随机、对照原则分为研究组和对照组,两组病人按等氮、等热量进行全胃肠外营养(TPN)支持。于TPN前1 d和TPN后第7天检测血清蛋白质、免疫和炎症指标。结果:1TPN后两组病人的血清前清蛋白、视黄醇结合蛋白、转铁蛋白明显增加,与TPN前比有显著性差异(P<0.05)。2TPN后两组病人的C-反应蛋白下降,血总淋巴细胞计数、T淋巴细胞亚群中的T辅助性淋巴细胞(CD4)、T辅助性淋巴细胞/抑制性淋巴细胞(CD4/CD8)比值升高,研究组与对照组比有显著性差异(P<0.05)。结论:含橄榄油的新型脂肪乳剂能提高危重症病人的免疫功能和降低炎性反应。Objective：To investigate the immune function and anti-inflammatory capacity of the olive oil based lipid emulsion compared with the traditional of median/long （MCT/LCT） fat emulsion application in critically ill patients.Methods：Fifty critical ill patients were prospectively enrolled and were randomly assigned to receive total parenteral nutrition （TPN） for 7 days.Patients were randomized into control group receiving TPN with a MCT/LCT fat solution and study group receiving TPN with olive oil based lipid emulsion.Plasma protein,C-reactive protein （CRP）,total lymphocyte count and T lymphocyte subgroup were measured.Results：After TPN,serum prealbumin,retinol binding protein and transferrin were significantly increased in two group.CRP decreased in two groups.The total lymphocyte count,CD4,CD4/CD8 were increased in study group and were significantly higher than those in the control group （P ＜ 0.05）.Conclusion：The olive oil based lipid emulsion can improve the immune function and reduce the inflammation in critically patients.

关 键 词：脂肪乳剂 橄榄油 中/长链脂肪乳 肠外营养 

分 类 号：R459.3[医药卫生—治疗学]