ω-3多不饱和脂肪酸对术后危重病人炎症反应以及营养的影响

Effect of ω-3 Polyunsaturated Fatty Acid on Inflammatory Response and Nutrition of Critical Illness Patients after Operation

【目的】研究ω-3多不饱和脂肪酸对术后危重病人炎症反应和营养状态的影响。【方法】选择术后需完全肠外营养支持的危重病患者40例，随机分为观察组和对照组，每组20例。两组患者术后连续行7d肠外营养支持治疗，观察组每天加用ω-3多不饱和脂肪酸10g。比较两组治疗前、治疗后2d和8d的炎症反应指标（白细胞、中性粒细胞和C反应蛋白水平）和营养状态指标（血清总蛋白、前白蛋白、转铁蛋白和淋巴细胞水平）以及手术前后体重变化（体重差）。【结果】术后2d两组患者炎症反应指标和营养状态指标水平比较，差异无统计学意义（P〉0．05）：术后8d观察组中性粒细胞和C反应蛋白水平均明显低于对照组，淋巴细胞水平明显高于对照组，差异有统计学意义（P〈0．05）。两组患者的体重差比较差异无统计学意义（P〉0．05）。【结论】ω-3多不饱和脂肪酸能够有效减轻术后危重病患者的炎症反应，改善患者的术后营养状态。

[Objective] To explore the effect of ω-3 polyunsaturated fatty acid（PUFA） on inflammatory re sponse and nutritional status of critical illness patients after operation. [Methods] Forty critical illness patients receiving total parenteral nutrition after operation were chosen and randomly divided into an observation group and control group with 20 cases in each group. Parenteral nutrition was conducted in continuous 7 days after operation. The observation group was additionally given ω-3 PUFA 10g every day. The inflammatory response indexes（white blood cell, neutrophil and C-reactive protein）, nutrition status indexes（serum total protein, prealbumin, transferrin and lymphocytes） before and 2d and 8d after treatment and the body weight change（body weight difference） before and after operation were compared between 2 groups. [Results] There was no significant difference in inflammation response and nutrition indexes 2d after operation between 2 groups（ P〉0.05）. The levels of neutrophils and C-reactive protein in observation group 8d after operation were obviously lower than those in control group, while the level of lymphoeytes in observation group was obviously higher than that in control group, and there were significant differences （ P〈0. 05）. There was no significant difference in body mass variance between 2 groups（ P〉0.05）. [Conclusion] ω-3 PUFA can effectively alleviate the inflammatory response of critical illness patients and improve the nutrition status after operation.