ω-3PUFA对TEM直肠癌术后患者血清IL-6、PCT及TNF-α水平及免疫功能的影响  

Effect of omega-3 polyunsaturated fatty acids on the levels of serum IL-6,PCT,TNF-αand and immune function after Transanal endoscopic microsurgery for rectal cancer

作　　者：李俊杰 李学灿[1] 张习文 LI Junjie;LI Xuecan;ZHANG Xiwen(Department of Oncology,Jiaozuo People's Hospital,Jiaozuo,Henan,454000)

机构地区：[1]焦作市人民医院肿瘤外科,河南焦作454000

出　　处：《航空航天医学杂志》2025年第4期397-400,共4页Journal of Aerospace medicine

摘　　要：目的探讨围术期应用ω-3多不饱和脂肪酸(ω-3PUFA)对经肛门内镜微创手术(TEM)直肠癌患者术后血清白细胞介素-6(IL-6)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)水平及免疫功能的影响。方法选取2020年01月-2024年02月于我院确诊并行经肛门内镜微创手术(TEM)的直肠癌的患者94例。按照随机数字表法分至研究组和对照组,各47例。术后两组均常规接受肠外营养支持治疗,其中研究组同时添加10 ml的ω-3PUFA。比较两组患者入院时及术后24h和7天血清炎症反应因子(IL-6、PCT、TNF-α)、营养学指标[血清总蛋白(TP)、白蛋白(ALB)、血红蛋白(Hb)、视黄醇结合蛋白(RBP)、转铁蛋白(TF)]、免疫功能指标标[免疫球蛋白(IgA、IgG、IgM)和外周血T淋巴细胞(CD3^(+)、CD4^(+)、CD8^(+))]水平。结果不同时间点,两组血清IL-6、PCT、TNF-α、TP、Hb、RBP、TF、IgA、IgG、CD3^(+)、CD4^(+)、CD8^(+)组内比较差异均有统计学意义(P<0.001);入院时、术后24h,研究组各指标与对照组比较差异均无统计学意义(P>0.05);术后7d,研究组血清IL-6、PCT、TNF-α水平低于对照组;血清TP、ALB、Hb、RBP、TF、IgG、CD3^(+)、CD4^(+)水平均高于对照组(P<0.001)。结论TEM直肠癌术后患者添加ω-3PUFA有利于下调血清炎症因子水平,提高病人的免疫功能,进而提升患者的营养水平,值得推广和应用。Objective To investigate the effect of omega-3 polyunsaturated fatty acids on the levels of serum IL-6,PCT,TNF-αand and immune function after Transanal endoscopic microsurgery for rectal cancer.Methods A total of 94 patients with rectal cancer diagnosed and treated with transanal endoscopic microsurgery(TEM)at our hospital from January 2020 to February 2024 were selected.Patients were randomly assigned to the study group and the control group,each consisting of 47 cases.Both groups received routine parenteral nutritional support after surgery,with the study group additionally receiving 10 ml ofω-3PUFA.Serum levels of inflammatory response factors(IL-6,PCT,TNF-α),nutritional markers[serum total protein(TP),albumin(ALB),hemoglobin(Hb),retinol-binding protein(RBP),transferrin(TF)],and immune function markers[immunoglobulins(IgA,IgG,IgM)and peripheral blood T lymphocytes(CD3^(+),CD4^(+),CD8^(+))]were compared between the two groups at admission and on postoperative 24h and 7.Results There were statistically significant differences within the groups at different time points for serum IL-6,PCT,TNF-α,TP,Hb,RBP,TF,IgA,IgG,CD3^(+),CD4^(+),and CD8^(+)(P<0.001).At admission and 24 hours postoperatively,there were no statistically significant differences in the markers between the study and control groups(P>0.05).On the 7th postoperative day,the study group had lower levels of serum IL-6,PCT,and TNF-α,and higher levels of serum TP,ALB,Hb,RBP,TF,IgG,CD3^(+),and CD4^(+)compared to the control group(P<0.001).Conclusion:The addition ofω-3PUFA to parenteral nutrition after TEM surgery for rectal cancer is beneficial in reducing serum inflammatory factor levels,improving immune function,and enhancing nutritional status in patients.It is worth promoting and applying.

关 键 词：直肠癌 Ω-3多不饱和脂肪酸 炎症因子 免疫功能 营养 

分 类 号：R735.37[医药卫生—肿瘤]