ω-3多不饱和脂肪酸对重度颅脑损伤患者免疫功能及炎性细胞因子的影响

Effects of ω-3 PUFA on cellular immune function and cytokine level in patients with severe brain injury

目的探讨ω-3多不饱和脂肪酸(ω-3 PUFA)对重度颅脑损伤患者细胞免疫的调节及抗炎作用。方法将34例重型颅脑损伤患者随机分为常规胃肠外营养组(TPN组)及ω-3 PUFA+TPN治疗组(PUFA组),每组17例。两组患者于治疗前与治疗后第3、7天分别抽取静脉血,应用直接免疫荧光法检测CD4,CD8,CD4/CD8及NK细胞水平,应用酶联免疫吸附法检测血清白细胞介素(IL)-6,C反应蛋白(CRP)及肿瘤坏死因子α(TNF-α)。结果与TPN组比较,PUFA组CD4,CD4/CD8明显升高(P<0.01或P<0.05),而CD8,IL-6,CRP及TNF-α水平明显下降(P<0.01或P<0.05)。结论ω-3 PUFA可显著改善重型颅脑损伤患者细胞免疫功能,抑制炎性细胞因子的表达。

Objective To investigate the effects of ω-3 polyunsaturated fatty acid （ω-3 PUFA） on cellular immune function and anti-inflammatory response in patients with severe brain injury. Method The 34 patients with severe brain injury were assigned randomly into 2 groups（n=17 in each）： conventional total parenteral nutrition group（TPN group） and ω-3 PUFA ＋TPN group（PUFA group）. Blood CD4, CD8, CD4/CD8 and NK-cell expression level was measured by direct immunofluorescenee; inter/eukin （IL）-6, C-reactive protein （CRP） and tumor necrosis factor-or （TNF-α） was measured by enzyme-linked immunosorbent assay （ELISA） before and on the 3rd, 7th day after parenteral nutrition. Results Compared with TPN group, the level of CD4, CD4/CD8 and NK-cell in PUFA group was increased significantly （P〈0.01 or P〈0.05）, but the level of CD8, IL-6, CRP and TNF-α was decreased significantly （P〈0.01 or P〈0.05）. Conclusion The application of 00-3 PUFA may improve the cellular immune function and suppress inflammatory reaction of patients with severe brain injury