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目的:研究鱼油(富含ω-3多不饱和脂肪酸)对严重创伤病人肠屏障功能变化和预后的影响。方法:对损伤严重度评分(ISS)≥16的26例严重创伤病人随机分为常规组(n=13)和鱼油组(n=13)。两组均采用等氮、等热量给药,分别于创伤后第1、3和6天采集外周血,同时设立对照组(n=10),采用酶学分光光度计法和ELISA法分别检测D乳-酸和肠型脂肪酸结合蛋白(IFABP)。记录全身炎症反应综合征(SIRS)发生率、感染并发症、最终结局和住院时间等,并进行组间比较。结果:严重创伤后血浆D乳-酸和血清IFABP水平均显著升高,尔后逐渐下降,但鱼油组较常规组下降更为显著;鱼油组较常规组SIRS发生率低。结论:鱼油有益于严重创伤后病人肠道血供和肠屏障功能的恢复,并能改善预后,降低SIRS的发生率。
Objective: To study the effects of fish oil (rich in ω-3 polyunsaturated fatty acids) on the changes of intestinal barrier function and prognosis in patients with severe trauma. Methods: Twenty-six patients with severe traumatic injury (ISS) ≥16 were randomly divided into routine group (n = 13) and fish oil group (n = 13). Both groups were treated with equal nitrogen and equal calorie dose. Peripheral blood was collected on the 1st, 3rd, and 6th day after trauma, while the control group (n = 10) was established. Enzyme spectrophotometry and ELISA were used to detect D Milk-acid and enteric-type fatty acid-binding protein (IFABP). The incidence of systemic inflammatory response syndrome (SIRS), infection complications, final outcome and length of stay were recorded and compared between groups. Results: Serum levels of D-lactate-acid and serum IFABP were significantly increased after severe trauma and gradually decreased after the trauma. However, the levels of SIRS in the fish oil group were significantly lower than those in the conventional group. Conclusion: Fish oil is beneficial to the recovery of intestinal blood supply and intestinal barrier function in severe traumatic patients, and can improve the prognosis and reduce the incidence of SIRS.