含ω-3鱼油脂肪乳肠外营养制剂对早期肠瘘炎症状态的影响  

Effects of parenteral nutrition containingω-3 fish oil fat emulsion on the inflammatory status of patients with intestinal fistula at the early stage

作　　者：周郑 魏坤建 许群 郭凯 宫婷 顾国胜 ZHOU Zheng;WEI Kun-jian;XU Qun;GUO Kai;GONG Ting;GU Guo-sheng(Department of General Surgery,Anhui NO.2 Provinicial People's Hospital,Hefei 230000,Anhui,China;Anhui No.2 Provincial People's Hospital Clinical College of Anhui Medical University,Hefei 230000,Anhui,China;The Fifth Clinical Medical College of Anhui Medical University,Hefei 230000,Anhui,China;Bengbu Medical University,Bengbu 233003,Anhui,China)

机构地区：[1]安徽省第二人民医院普通外科,安徽合肥230000 [2]安徽医科大学安徽省第二人民医院临床学院,安徽合肥230000 [3]安徽医科大学第五临床医学院,安徽合肥230000 [4]蚌埠医科大学,安徽蚌埠233003

出　　处：《肠外与肠内营养》2025年第1期15-22,共8页Parenteral & Enteral Nutrition

基　　金：安徽省高等学校科学研究项目(2022AH052319、2023AH053376);安徽省卫生健康科研项目(AHWJ2022a026)。

摘　　要：目的:研究含ω-3鱼油脂肪乳的肠外营养制剂对早期肠瘘病人炎症状态的影响。方法:回顾性分析2023年11月至2024年5月在安徽省第二人民医院普外六科就诊的早期肠瘘病人28例,根据肠外营养中是否添加含ω-3鱼油脂肪乳分为对照组(n=15,单纯肠外营养治疗组)和研究组(n=13,肠外营养治疗+ω-3鱼油脂肪乳)。观察比较两组病人一般资料、血液中炎症因子、营养及免疫情况,收集入院第1天和第14天时的粪便,采用16SrRNA高通量测序肠道菌群。结果:两组病人一般资料以及入院第1天时的炎症、营养、免疫状况和肠道菌群之间的差异均无统计学意义(P>0.05),两组具有可比性。经过两周的肠外营养支持治疗,研究组和对照组病人红细胞计数、白细胞计数、血小板计数、淋巴细胞计数、C反应蛋白、谷氨酰转肽酶、天门冬氨酸氨基转移酶、丙氨酰氨基转移酶、总胆红素、直接胆红素、总蛋白、白蛋白、肌酐水平无统计学差异(P>0.05),而研究组中性粒细胞计数和血尿素氮水平显著低于对照组(P=0.03和P=0.01)。此外,研究组肠道菌群的丰度明显高于对照组,治疗两周后两组病人细菌属水平上Bacteroides_uniformis、Parabacteroides_merdae、Alistipes_finegoldii、Streptococcus_constellatus、Christensenella_minuta菌群丰度存在差异(P<0.05)。结论:含ω-3鱼油脂肪乳的肠外营养制剂能够降低早期肠瘘病人中性粒细胞计数,可能能够减轻炎症。Objective:To study the effects of parenteral nutrition containingω-3 fish oil fat emulsion on the inflammatory status of patients with intestinal fistula at the early stage.Methods:A retrospective analysis was conducted on 28 patients with intestinal fistula who were admitted to the Sixth Department of General Surgery of Anhui Provincial Second People's Hospital from November 2023 to May 2024.The patients were either divided into control group(n=15,parenteral nutrition alone group)or study group(n=13,parenteral nutrition plusω-3 fish oil fat emulsion)according to whetherω-3 fish oil fat emulsion was added to parenteral nutrition.Both groups of patients received parenteral nutrition support treatment,and the study group was givenω-3 fish oil fat emulsion during treatment.The general information,inflammatory factors in the blood,nutrition,and immune status of two groups of patients were collected and compared.The feces samples on the first and 14th day of admission were collected and analyzed by 16S rRNA high-throughput sequencing of gut microbiota.Results:There was no statistically significant difference in the general information,inflammation,nutrition,immune status,and gut microbiota between the two groups of patients on the first day of admission(P>0.05),indicating comparability between the two groups.After two weeks of parenteral nutrition support,the counts of red blood cells,white blood cells,platelets,lymphocytes,and levels of C-reactive protein,glutamate-pyruvate transaminase,aspartate aminotransferase,total bilirubin,direct bilirubin,total protein,albumin,and creatinine in the research group were similar to those in the control group without statistically significant differences(P>0.05).However,the counts of neutrophils and levels of blood urea nitrogen in the study group were significantly lower than those in the control group(P=0.03 and P=0.01).In addition,the abundance of intestinal flora in the study group was significantly higher than that in the control group(P<0.05).At the genus level,the abund

关 键 词：肠瘘 肠外营养 Ω-3鱼油脂肪乳 炎症 肠道菌群 

分 类 号：R453.9[医药卫生—治疗学]