ω-3鱼油脂肪乳联合胸腺肽α1对重症急性胰腺炎患者的临床疗效

Clinical Efficacy of Omega-3 Fish Oil Lipid Emulsions Combined with Thymosin Alpha 1 in Severe Acute Pancreatitis Patients

目的:观察ω-3鱼油脂肪乳联合胸腺肽α1能否改善重症急性胰腺炎患者机体早期炎症反应、器官功能及临床预后。方法:选取96例SAP病人分成三组,ω-3+胸腺肽α1组(n = 34)、ω-3组(n = 32)、对照组(n = 30)。三组患者均使用相等氮量及热量的肠外营养,分别在治疗前和治疗后7天抽取静脉血,检测WBC、血淀粉酶、尿淀粉酶、血糖、血钙等生化指标,C反应蛋白(CRP)、降钙素原(PCT)等炎性指标,同时记录肝、肺、肾等器官功能指标,并观察患者恢复情况。结果:治疗后7天,ω-3+胸腺肽α1组与ω-3组WBC、血淀粉酶、尿淀粉酶、血糖较对照组降低(P < 0.05),且ω-3+胸腺肽α1组WBC、血淀粉酶、尿淀粉酶较ω-3组明显降低(P < 0.05);ω-3+胸腺肽α1组与ω-3组血钙水平较前升高(P < 0.05),ω-3+胸腺肽α1组及ω-3组血钙水平较对照组升高(P < 0.05);ω-3+胸腺肽α1组与ω-3组患者血CRP、PCT较对照组降低(P < 0.05),且ω-3+胸腺肽α1组CRP、PCT较ω-3组明显降低(P < 0.05);ω-3+胸腺肽α1组及ω-3组白蛋白、氧合指数较对照组升高(P < 0.05),且ω-3+胸腺肽α1组白蛋白、氧合指数较ω-3组明显升高(P < 0.05);ω-3+胸腺肽α1组与ω-3组ARDS患病率较对照组降低,且ω-3+胸腺肽α1组较ω-3组明显降低(P < 0.05);ω-3+胸腺肽α1组并发感染数较ω-3组及对照组明显减少(P < 0.05),且ICU时间短于ω-3组及对照组(P < 0.05)。结论:添加ω-3鱼油脂肪乳的肠外营养联合胸腺肽α1能降低重症急性胰腺炎患者早期炎症反应,保护器官功能,改善临床预后。

Objective: To study whether omega-3 fish oil lipid emulsions combined with Thymosin Alpha 1 can improve inflammatory reaction, organ function and prognosis in severe acute pancreatitis patients. Methods: Ninety-six severe acute pancreatitis patients were divided into ω-3 plus Thymosin Alpha 1 group (n = 34), ω-3 group (n = 32), control group (n = 30). All the three groups received parenter-al nutrition with the same amount of nitrogen and calories. The patient’s biochemical indicators (white blood cells, blood amylase, urine amylase, blood glucose, blood calcium) and inflammatory indicators (C reactive protein, procalcitonin) and organ function indicators were measured before the treatment and on the eighth day after the treatment, and to evaluate the recovery of these pa-tients. Results: On the eighth day after the treatment, the WBC, blood amylase, urine amylase and blood glucose in ω-3+ Thymosin Alpha 1 group and ω-3 group were lower than those in control group (P < 0.05), and WBC, blood amylase and urine amylase in ω-3+ Thymosin Alpha 1 group were significantly lower than those in ω-3 group (P < 0.05). The serum calcium level in ω-3+ Thymosin Alpha 1 and ω-3 groups was higher than that in the control group (P < 0.05), and that in ω-3+ Thy-mosin Alpha 1 and ω-3 groups was higher than that in the control group (P < 0.05). Compared with the control group, CRP and PCT in ω-3+ Thymosin Alpha 1 and ω-3 group were decreased (P < 0.05), CRP and PCT in ω-3+ Thymosin Alpha 1 group were significantly decreased (P < 0.05). The albumin and oxygenation index in ω-3+ Thymosin Alpha 1 group and ω-3 group were significantly higher than those in control group (P < 0.05), and the albumin and oxygenation index in ω-3+ Thymosin Alpha 1 group were significantly higher than those in ω-3 group (P < 0.05). Compared with the con-trol group, the prevalence of ARDS in ω-3+ Thymosin Alpha 1 and ω-3 groups was significantly low-er than that in ω-3 group (P < 0.05). The number of concurrent infections in ω-3+ Thymosin Alpha 1 group was significantly lower than that in ω-3 group and control group (P < 0.05), and the ICU time was shorter than that in ω-3 group and control group (P < 0.05). Conclusion: The combination of parenteral nutrition supplemented omega-3 fish oil lipid emulsions and Thymosin Alpha 1 can sig-nificantly improve the inflammatory reaction of patients, protect organ function, and improve prognosis.