ω-3多聚不饱和脂肪酸对严重多发伤早期患者白细胞等指标及预后的影响

Effects of ω-3 Polyunsaturated Fatty Acids on the Severe Multiple Trauma Patients' White Blood Cells at Early Stage and Relative Prognosis

目的 探究ω-3多聚不饱和脂肪酸（ω-3PUFA）对严重多发伤早期患者白细胞等多项指标及预后的影响.方法 从2010年8月～ 2013年7月来笔者医院急诊的严重多发伤患者中随机抽取74例患者,随机分组为治疗组（n =39）和对照组（n=35）,比较两组患者在血糖、白细胞、血清C-反应蛋白和全身炎性反应综合征（SIRS）评分等指标及预后上的差异.结果 治疗组患者白细胞和SIRS评分在肠外营养治疗第3天开始显著下降,而血清C反应蛋白和血糖仅从第5天开始显著降低,差异均有统计学意义（P＜0.05）.随着治疗延长,ω-3PUFA对严重多发伤患者不同指标的影响更明显,除血糖外其他各指标在治疗第7天均有极显著性减少（P＜0.01）,有效抑制炎性反应和血糖升高.该肠外营养辅助治疗对住院时间无明显影响,但能显著降低SIRS发生率、MOF发生率和病死率（P＜0.05）.结论 ω-3PUFA能抑制全身性炎性反应程度,保护机体免受过度炎性反应的损伤,降低患者病情恶化及死亡风险.

Objective To explore the effects of ω - 3 polyunsaturated fatty acids （ ω- 3PUFA） on a number of indicators （ e. g. white blood cells） of severe multiple injuries at early stage and related prognosis. Methods From August 2010 to July 2013, 74 cases of patients with severe multiple injuries in our hospital emergency were randomly selected and randomized into treatment group （n = 39） and control group （n = 35）. The differences between indicators such as glucose, white blood cells, serum C - reactive protein, systemic in- flammatory response syndrome （SIRS） score and other prognostic indicators were compared between each group. Results White blood cells and SIRS scores of patients in treatment group began to decline significantly at day 3, while serum C - reactive protein and glucose only reduced at day 5 （P 〈 0. 05）. With prolonged treatment, the impact of ω -3PUFA on different indicators of severe multiple trauma patients were more obvious. Various indicators except blood glucose at day 7 were highly significant reduced （P 〈 0.01 ）. The parenteral nutrition adjuvant therapy had no significant effect on the period of hospital stay, but significantly reduced the incidences of SIRS, MOF and mortality （P 〈 0.05）. Conclusion ω -3PUFA could inhibit the degree of systemic inflammation, protecting the body from exces-sive inflammation damage and reducing the risk of disease progression and death.