脂肪乳剂对重症胰腺炎患者细胞因子的影响

Effect of Fat Emulsion on Cytokines in Severe Acute Pancreatitis Patients

目的探讨重症急性胰腺炎早期细胞因子与游离脂肪酸的变化及脂肪乳剂对其影响.方法 30例患者随机分为长链脂肪乳剂组(L组),中/长链脂肪(M组),未用脂肪乳剂组(C组),予以肠外营养支持7d,测定TNF、IL-6、CRP和FFA变化,并计算其相关性.结果 TNF、IL-6、CRP在入院后第3d时明显升高,1周后下降,组内变化较明显(P＜0.05～P＜0.01),FFA在入院第3d轻度升高,1周后已降至正常;TNF和FFA变化呈正相关(r=0.84,P＜0.01).结论重症急性胰腺炎发病早期细胞因子和游离脂肪酸的变化与病程进展一致,TNF对FFA代谢有一定的影响.脂肪乳剂对FFA代谢无明显影响,能够较好地氧化供能.

Objective To Study the change of cytokines and free fatty acids（FFA） and the effect of fat emulsion in patients with severe acute pancreatitis. Methods Thirty cases with acute pancreatitis were randomly divided into intralipid（L） group , lipovenves group（M） and not fat group（C）. The total parenteral nutrition duration was 7 days. Tumor necrotic factor （TNF）, interleukin- 6 （IL- 6）, C- reactive protein （CRP） and FFA was determined. Results The serum level of cytokines was significantly increased in the 3rd day, decreased after 7th day; FFA was mild increased in 3rd day, and decreased to the normal level after a week（ P 〈 0.05 -- P 〈 0.01 ）. There was positive correlation between TNF and FFA（ r = 0.84, P 〈 0.01 ）. Conclusions The change of cytokine and FFA was rdated to the severity of pancreatitis. TNF can cause the increase of FFA in some degree. Fat emulsion has no obvious effect on the FFA metabolism in patients with pancreatitis.