多种油脂肪乳对癌症患者术后非特异性炎症、肝肾功能和营养状态的影响

Effect of multi-oil fat emulsion injection on non-specific inflammation,liver and kidney function and nutritional status in cancer patients

目的探讨多种油脂肪乳(SMOF)对癌症患者术后非特异性炎症、肝肾功能和营养状态的影响,指导临床合理应用。方法回顾性纳入某院2020年1月1日至2023年5月31日使用SMOF和中长链脂肪乳(MCT/LCT)的患者,根据脂肪乳剂的种类分为SMOF组(试验组,n=47)和MCT/LCT组(对照组,n=79),记录两组患者非特异性炎症、肝肾功能和营养指标的变化。结果重复测量方差分析结果显示,在不限年龄的癌症组中,两组患者的CRP、WBC、TBIL、TP的时间效应和组间效应差异有统计学意义(P<0.05),ALB的时间效应差异有统计学意义(P<0.05);试验组治疗后7日CRP水平低于对照组,治疗后3日和治疗后7日WBC水平低于对照组,TBIL上升的幅度小于对照组,TP水平显著高于对照组(P<0.05),其他指标差异无统计学意义。在老年癌症组中,两组患者的CRP、WBC、TBIL、TP的时间效应和组间效应差异显著(P<0.05),ALB的时间效应差异显著(P<0.05);试验组治疗后3日和治疗后7日CRP、WBC水平低于对照组,TP水平显著高于对照组;试验组治疗后3日TBIL上升的幅度小于对照组(P<0.05),其他指标差异无统计学意义。结论与MCT/LCT相比,SMOF应用于癌症患者术后包括老年癌症患者术后均有减轻炎症反应、保护患者肝脏功能和改善患者营养状态的作用,并且安全,在营养治疗方面有优势。

Objective To determine the effect of multi-oil fat emulsion injection(SMOF)on the nonspecific inflammation,liver and kidney function and nutritional status in cancer patients after the surgery.Methods Patients who received SMOF and medium and long chain fat emulsion injection(MCT/LCT)from January 1st 2020 to 31st May 2023 were classified into a SMOF(the test group,n=47)and a MCT/LCT group(the control group,n=79)according to the type of fat emulsion,and recorded changes in non-specific inflammation,liver and kidney function,and nutritional indicators in both groups.Results Repeated measurement of analysis of variance(ANOVA)showed that in the non-age-limited cancer group,the time effect and intergroup effect differences in C-reactive protein(CRP),white blood cell count(WBC),total bilirubin(TBIL)and total protein(TP)of patients in both groups were significant(P<0.05).The time effect difference in ALB was significant(P<0.05).The CRP level of the test group was lower than that of the control group 7 days after the treatment,the WBC level 3 days and 7 days after the treatment was lower than that of the control group,the increase in TBIL was less than in the control group,and the TP level was higher than that of the control group(P<0.05).The difference in other indicators was not significant.In the elderly cancer group,the time effect and intergroup differences in CRP,WBC,TBIL and TP of both groups of patients were significant(P<0.05),and the time effect difference in ALB was significant(P<0.05).The CRP and WBC levels of the experimental group were lower than those of the control group 3 days and 7days after the treatment,and the TP levels was significantly higher than that of the control group.The increase in TBIL 3 days after the treatment in the experimental group was less than that of the control group(P<0.05),and the differences in other indicators were not significant.Conclusion Compared with MCT/LCT,SMOF used for cancer patients after the surgery,including in elderly cancer patients,can reduce the inflammatory responses,protect patients'liver function and improve patients'nutritional status safely.