强化ω-3多不饱和脂肪酸的肠内营养支持对高脂血症性急性胰腺炎患者免疫功能的影响

Clinical study on effects of enteral nutrition addingω-3 PUFA on the immune function of patients with hyperlipidemic acute pancreatitis

目的探讨强化ω-3多不饱和脂肪酸的肠内营养支持对高脂血症性急性胰腺炎患者免疫功能的影响。方法将80例高脂血症性急性胰腺炎患者按随机数字表法分为治疗组40例和对照组40例。2组患者均给予急性胰腺炎规范治疗,对照组给予肠外营养支持,治疗组经空肠营养管给予强化ω-3多不饱和脂肪酸的肠内营养支持。治疗后比较2组患者营养指标、体液免疫指标和细胞免疫指标、炎症反应指标的变化情况。结果2组患者给予不同营养方式治疗后,治疗第7天、14天时血清白细胞(ALB)和血清前白蛋白(PAB)水平以治疗组提高更为显著(均P<0.05)。治疗第14天时IgA,IgG,IgM,淋巴细胞总数(TLC),CD3,CD4以治疗组上升更显著(均P<0.05);同时2组患者治疗后的CRP,TNF-α,IL-6水平呈现下降趋势,治疗组下降更显著(均P<0.05)。结论强化ω-3多不饱和脂肪酸的肠内营养支持治疗高脂血症性急性胰腺炎患者能更加有效地改善患者营养状况及免疫功能,降低患者急性反应期炎症反应,从而改善预后、提高临床疗效。

Objective To investigate the effect of enteral nutrition adding ω-3PUFA on the immune function of patients with hyperlipidemic acute pancreatitis. Methods Eighty patients with hyperlipidemic acute pancreatitis were randomly divided into treatment group and control group, 40 cases in each group. All patients were treated with conventional treatment, control group received parenteral nutrition support, treatment group were received enteral nutrition adding ω-3 PUFA therapy. Nutrition indicators, humoral immunity, cellular immunity and in- flammation index changes were compared between the two groups of patients after treatment. Results The ALB and PAB levels of the two groups at 7 days and 14 days increased after treatment, which increased more obviously in treatment group （P〈0.05）. The increase of humoral immunity （IgA, IgG, IgM） and cellular immunity （TLC, CD3,CD4） of treatment group was more significant than those of control group after the 14 days of treatment （P 〈0.05）. At the same time, inflammation index （CRP,TNF-α, IL-6）of the treatment group were decreased significantly compared with control group（P〈0.05）. Conclusion Enteral nutrition adding 00-3 PUFA can more effectively improve the nutrition indicators and immunological function of patients with hyperlipidemic acute pancreatitis, reduce the acute period inflammation reaction of patients, thus improving prognosis and promoting recovery of the patients.