鱼油脂肪乳注射液对肝移植术后肝功能及机体免疫功能的影响

The application of ω-3 fish oil fatty emulsion in the early stage of liver transplantation

目的观察鱼油脂肪乳注射液对肝移植术后肝功能恢复、免疫功能和炎性反应的影响。方法将64例肝移植患者随机分为治疗组和对照组（n=32），对照组采用常规免疫抑制和静脉营养治疗，治疗组在上述治疗的基础上加用ω-3鱼油脂肪乳剂。检测治疗1周后的肝功能、肿瘤坏死因子（TNF）-α和白细胞介素（IL）-1水平，比较排斥反应和感染的发生率。结果治疗组和对照组患者的肝功能、排斥反应发生率（12．5％比9．4％），感染率（18．8％比25．0％）差异无统计学意义（P〉0．05），死亡率分别为0和6．25％。治疗组TNF-α、IL-1水平较术前明显下降（P〈0．05），也明显低于对照组（P〈0．05）。结论 ω-3鱼油脂肪乳剂运用于肝移植术后不影响肝功能恢复，在不干扰免疫抑制治疗的同时，可以减少炎症介质的释放，改善重度感染的预后。

Objective To evaluate the effect of omega-3 fatty enmlsion on liver function, immune function and inflammatory reaction following liver transplantation. Methods Sixty-four patients who had undergone liver transplantation from January 2008 to December 2009 were equally divided into therapeutic group and control group （n = 32）. After liver transplantation, the control group was treated routinely, on the basis of conventional therapy, and the patients in the therapeutic group were added with ω-3 fish oil fatty emulsion. At the 10th day, the liver function, levels of cytokines [ tumor necrosis factor （TNF）, interleu kin （IL）-1 ] and incidence of ,＇ejection and infection were compared. Results There were no significant differences in liver function, the incidence of rejection （ 12. 5% vs. 9. 4% ） and infection （ 18.8% vs. 25.0% ） between the two groups. The mortality was 0 in therapeutic group and 6. 25% in control group. The levels of TNF-α and IL-1 level in therapeutic group were significantly lower than in control group （ P 〈0. 05 ）, also lower than those before operation （P 〈 0. 05 ）. Conclusion It is effective and safe to use ω-3 fish oil fatty emulsion in the early stage of liver transplantation. Without interfering with the immune suppression, It reduces the release of inflammatory mediators and improves the prognosis of severe infection.