ω-3多不饱和脂肪酸对老年股骨骨折术后免疫反应的影响  

Effects of ω-3 PUFA on immune reaction subsequent to surgical treatment for femoral fractures in elderly

作　　者：刘文清[1] 李彦[1] 陈君生 许会彬[1] LIU Wen-qing;LI Yan;CHEN Jun-sheng;XU Hui-bin(The 960th Hospital of PLA,Tai'an 271000,China)

机构地区：[1]中国人民解放军联勤保障部队第960医院

出　　处：《中国矫形外科杂志》2019年第22期2059-2062,共4页Orthopedic Journal of China

摘　　要：[目的]探讨ω-3多不饱和脂肪酸(ω-3 PUFA)对老年股骨骨折患者术后炎性介质及T淋巴细胞亚群的影响。[方法]将42例股骨骨折手术治疗老年患者随机分为常规胃肠外营养组(TPN组)及ω-3 PUFA+TPN治疗组(PUFA组),每组21例。两组患者于术后第1、3、5 d分别抽取静脉血,检测血清淀粉样蛋白(SAA)、C反应蛋白(CRP)和8-异前列腺素F2a (8-iso-PGF2a),此外,流式细胞仪检测T细胞亚群。[结果]术后1 d两组间SAA、CRP及8-iso-PGF2a的差异无统计学意义(P>0.05),但是术后3 d和5 d,PUFA组的SAA、CRP和8-iso-PGF2a均显著低于TPN组(P<0.05)。随术后时间推移,两组患者的SAA、CRP和8-iso-PGF2a均显著下降(P<0.05)。术后1 d两组间CD4、CD8、CD4/CD8和NK比率的差异无统计学意义(P>0.05);术后3 d PUFA组的CD4、CD4/CD8和NK比率显著高于TPN组(P<0.05),而两组间CD8比率的差异无统计学意义(P>0.05);术后5 d PUFA组的CD4、CD4/CD8和NK比率显著高于TPN组(P<0.05),而PUFA组CD8比率显著低于TPN组(P>0.05)。随术后时间推移,两组患者的CD4、CD4/CD8和NK比率均显著增加,而两组的CD8比率均显著下降,不同时间点间差异有统计学意义(P<0.05)。[结论]ω-3 PUFA可显著抑制老年股骨骨折患者术后炎性介质的表达,改善细胞免疫功能。[Objective] To investigate the effects of ω-3 polyunsaturated fatty acid(ω-3 PUFA) on immune reaction after operation for lower limb fracture in elderly. [Method] A total of 42 elderly patients who underwent surgical treatment for femoral fracture were randomly divided into 2 groups with 21 patients in each group. The patients who had conventional total parenteral nutrition(TPN) only were termed as the TPN group, while those who received ω-3 PUFA combined with TPN were named as the PUFA group. The serum amyloidprotein(SAA), C-reactive protein(CRP) and 8-iso-prostaglandin F2a(8-iso-PGF2a)were measured, additionally, the CD4, CD8, CD4/CD8 and NK-cell were assessed by flow cytometer at 1, 3 and 5 days after operation. [Results] Although there were no statistically significant differences in SAA, CRP and 8-iso-PGF2a between two groups at 1 day postoperatively, the PUFA group had significantly lower SAA, CRP and 8-iso-PGF2a than the TPN group at 3 and 5 days postoperatively(P<0.05). The aforesaid inflammatory parameters significantly decreased as time went in both group(P<0.05). As results of T lymphocyte flow cytometer, there were no statistically significant differences regarding CD4, CD8,CD4/CD8 and NK cells between the two groups at 1 day postoperatively(P>0.05). However, the PUFA group had significantly higher CD4, CD4/CD8 and NK cells than the TPN group(P<0.05), regardless no a significant difference in CD8 cells between them at 3 days postoperatively(P>0.05). The PUFA group proved significantly higher CD4, CD4/CD8 and NK cells, while significantly lower CD8 cells than the TPN group at 5 days postoperatively(P<0.05). The CD4, CD4/CD8 and NK cells significantly increased, while the CD8 cells decreased over time postoperatively in both group(P<0.05). [Conclusions] The ω-3 PUFA might suppress inflammatory reaction and improve the cellular immune function after operation for femoral fractures in elderly.

关 键 词：股骨骨折 老年 Ω-3多不饱和脂肪酸 炎性因子 细胞免疫 

分 类 号：R683.42[医药卫生—骨科学]