ω-3脂肪酸对脓毒症病人治疗的影响

Influence of ω-3 fatty acids on the therapy of sepsis patients

目的:探讨ω-3脂肪酸对脓毒症病人的免疫调节和抗炎作用。方法:将18例病人随机分为鱼油治疗组和常规治疗组。鱼油治疗组病人为常规治疗加鱼油,并于治疗前和治疗后第5天用流式细胞仪检测单核细胞HLA-DR表达率,同时检测炎症反应指标,包括C反应蛋白(CRP)、IL-6和肿瘤坏死因子α(TNF-α),观察病情严重程度(APACHEⅡ评分)和氧合指数(PaO2/FiO2)的变化。结果:相对于常规治疗组,鱼油治疗组病人血清CRP、IL-6和TNF-α均明显下降;氧合指数改善;单核细胞HLA-DR表达率、APACHEⅡ评分较常规治疗组无显著性差异。结论:应用ω-3脂肪酸可使脓毒症病人血清炎症介质表达减少,但对单核细胞HLA-DR的表达未见调节作用。

Objective：To investigate the immune regulation mechanism and anti-inflammatory effect of ω-3 fatty acids on sepsis patients. Methods： Totle 18 patients were divided into two groups, therapy group and control group. The control group was given routine therapy while the theray group was given routine therapy and fish oil. The expression of HLA-DR on peripheral monocytes was measured by flow cytometry at the beginning and 5 d during therapy, in parallel with serum c-reactive protein（CRP） ,inter- leukin-6 （ IL-6 ）, tumor necrosis factor-c~ （ TNF-α）, and severity of the disease （ APACHE 11 score）, serum and oxygenation index（ PaO2/FiO2 ） Results： Compared with conventional group, serum concentration of CRP, IL-6 and TNF-α in patients of therapy group were significantly reduced, and oxygenation index im- proved. There was no difference in the expression of HLA-DR and APACHE Ⅱ score between two groups. Conclusion：Fish oil can decrease the elevated mediators of inflammation on sepsis patients, and cant regulation the expression of HLA-DR on peripheral monocytes.