SMOF脂肪乳剂对腹部中等手术后病人脂肪酸和炎性介质的影响

Effect of SMOF fat emulsion on fatty acid profile and inflammatory mediator of in major abdominal surgical patients

目的:观察大豆油、中链三酰甘油、橄榄油、鱼油和维生素E(SMOF)脂肪乳剂对腹部中等手术后病人脂肪酸和炎性介质的影响。方法:选择48例腹部中等手术后需要肠外营养支持至少5 d以上的病人,按前瞻、随机、盲法、对照原则分为SMOF组24例和英脱利匹特(Intralipid)组24例。术后第1～5天两组病人按等氮、等热量进行肠外营养支持。于手术前、术后第1,4和6天,检测游离脂肪酸、白细胞三烯(LTB5、LTB4)、血栓素(TXB3、TXB2)、白细胞介素(IL-1、IL-2和IL-6)。结果:与术后第1天相比,两组病人的游离脂肪酸谱、LTB5/LTB4、TXB2/TXB3和IL-2差异显著,IL-1、IL-6无显著差异,但SMOF组较对照组明显降低。结论:SMOF可明显降低腹部中等手术后病人的炎性介质和细胞因子。

Objective： To assess the effects of SMOF 20% on fatty acid profile and inflammatory mediators in surgical patients.Methods： In a prospective and double-blind study,postoperative patients were randomized to receive isonitrogenous,isocaloric total parenteral nutrition over 5 days including either SMOF 20% or Intralipid 20%.Blood samples were drawn for determination of fatty acid pattern,LTB,TXB and IL.Results： The 2 groups were similar with respect to demographic characteristics.The shares of EPA and DHA were highly increased but that of arachidonic acid（AA） was decreased with SMOF.LTB5 and TXB3 were enhanced and LTB4 and TXB2 were lowered significantly with SMOF.IL-2 was lowered significantly with SMOF.Conclusion： Treatment with SMOF is well tolerated,and the changes of inflammatory mediators may be favourable in anti-inflammatory effects.