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目的:探讨ω-3多不饱和脂肪酸对急性胰腺炎患者血清炎症介质释放的影响。方法:将40例急性胰腺炎患者随机分为常规全胃肠外营养的观察组(20例)和全胃肠外营养加用ω-3多不饱和脂肪酸的治疗组(20例)。2组患者均接受等热量、等氮的全胃肠外营养,热量20kcal/(kg.d)、氮摄入量0.2g/kg,其中治疗组加用ω-3多不饱和脂肪酸2mL/(kg.d),共7d,治疗前和治疗后1、5、7d分别检测白细胞介素-1、白细胞介素-6、血清肿瘤坏死因子-α;比较2组患者ICU住院时间、多器官功能障碍综合症发生率。结果:联用ω-3多不饱和脂肪酸治疗后,治疗组在不同时间点白细胞介素-1、白细胞介素-6及血清肿瘤坏死因子-α均明显低于观察组(P<0.05或P<0.01);治疗组ICU住院时间明显缩短(P<0.05),多器官功能障碍综合征发生率明显下降(P<0.05)。结论:ω-3多不饱和脂肪酸可降低急性胰腺炎患者白细胞介素-1、白细胞介素-6、肿瘤坏死因子-α水平,降低多器官功能障碍综合征发生率,缩短ICU住院时间。
Objective: To investigate the effect of ω-3 polyunsaturated fatty acids on the release of serum inflammatory mediators in patients with acute pancreatitis. Methods: Forty patients with acute pancreatitis were randomly divided into conventional total parenteral nutrition group (20 cases) and total parenteral nutrition plus omega-3 polyunsaturated fatty acid treatment group (20 cases). The patients in two groups received equal total parenteral nutrition such as nitrogen, total calories of 20 kcal / (kg · d), and nitrogen intake of 0.2 g / kg. The patients in the treatment group received 2 mL of ω-3 polyunsaturated fatty acid / ( kg.d) for 7 days. The levels of interleukin-1, interleukin-6 and serum tumor necrosis factor-alpha were measured before treatment and at 1, 5 and 7 days after treatment. The hospital stay, multiple organ function Disorder syndrome incidence. Results: After treatment with omega-3 polyunsaturated fatty acids, the levels of interleukin-1, interleukin-6 and serum tumor necrosis factor-α in the treatment group were significantly lower than those in the observation group at different time points (P <0.05 or P <0.01). The hospitalization time of ICU in the treatment group was significantly shorter (P <0.05), and the incidence of multiple organ dysfunction syndrome was significantly decreased (P <0.05). CONCLUSION: Omega-3 polyunsaturated fatty acids can reduce the levels of interleukin-1, interleukin-6 and tumor necrosis factor-α in patients with acute pancreatitis, reduce the incidence of multiple organ dysfunction syndrome and shorten the hospital stay of ICU.