ω-3多不饱和脂肪酸改善COPD患者IMV期间细胞免疫功能

ω-3 PUFA Improves Immunologic Function of COPD Patients in IMV

目的探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)有创机械通气(Invasive Mechanical Ventilation,IMV)患者使用ω-3多不饱和脂肪酸(PUFA)治疗后细胞免疫功能变化。方法纳入我院于2008年9月至2010年9月期间,重症监护室收治的38例COPD行IMV患者作为研究对象。所有研究对象随机进入治疗组与对照组。治疗组给予ω-3PUFA制剂;对照组则给予普通脂肪乳剂治疗;分别于IMV第1、5天采集清晨空腹静脉血标本各2ml,以流式细胞仪检测T细胞亚群:CD3+、CD4+、CD8+、CD4+/CD8+。结果第1天CD3+、CD4+、CD8+、CD4+/CD8+两组间进行比较,均无统计学意义(P>0.05);第5天CD3+、CD4+、CD8+、CD4+/CD8+两组间进行比较,均有统计学意义(P<0.01)。研究组第5天与第1天CD3+、CD4+、CD8+、CD4+/CD8+进行比较,均有统计学意义(P<0.01),其中CD3+、CD4+、CD4+/CD8+较前明显升高,CD8+较前明显降低。结论ω-3PUFA在COPD患者IMV期间使用,可以起到调节免疫反应、改善细胞免疫状态的作用,是COPD患者IMV期间必要的治疗措施之一。

Objective To investigate the changes of immunologic function of COPD patients in IMV while using ω-3 PUFA. Methods 38 COPD patients in IMV were erolled in this study,who were admitted in ICU from Sep. 2008 to Sep. 2010. All patients were erolled randomly in study group or controlled group. ω-3 PUFA was used in study group,and common lipid emulsion was used in controlled group. 2 ml venous blood specimen was collected in the 1st and 5th day after IMV,which was used for detecting T cell subgroup by flow cytometry,including CD3＋,CD4＋,CD8＋ and CD4＋/CD8＋. Results At the 1st day after IMV,there was no significant difference between two groups in CD3＋,CD4＋,CD8＋ and CD4＋/CD8＋（P 0.05） . At the 5th day after IMV,there was significant difference between two groups in CD3＋,CD4＋,CD8＋ and CD4＋/CD8＋（P 0.01） . In study group,there was significant difference in CD3＋,CD4＋,CD8＋ and CD4＋/CD8＋ between the 1st and 5th day after IMV（P 0.01） . CD3＋,CD4＋,CD4＋/CD8＋ increased obviously and CD8＋ significantly decreased. Conclusion ω-3 PUFA plays an immunoregulatory effects in COPD patients while IMV,which will be an necessary remedy for these patients.