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ω-3鱼油脂肪乳对肝移植术后炎症、免疫及预后影响的前瞻性研究
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Journal Article
ω-3鱼油脂肪乳对肝移植术后炎症、免疫及预后影响的前瞻性研究
2012
Overview
目的探讨ω-3鱼油脂肪乳对肝移植术后炎症、免疫及预后的影响。方法2009年l月-2010年12月枉解放军81医院肝移植中心行同种异体原位肝移植的患者36例，前瞻性随机分为鱼油组（18例）和对照组（18例）。术后第2天开始予等氮等热量的营养支持，共6d。分别于术前及术后第2、5、8天抽取外周静脉血，检测细胞因子（IL-1β、IL-2、IL-6、IL-10、TNF-α）、C反应蛋白（CRP）、淋巴细胞亚群（CD4＋、CD8＋、HLA．DR＋）；观察和记录术后重症监护时间、术后住院时间以及急性排斥反应发生率、感染发生率和死亡率等。结果两组肝移植术后细胞因子水平均高于术前。鱼油组术后IL-1β、IL-2、IL-6、TNF-α水平显著低对照组（P〈0．05或P〈0．01）；术后第5天CRP显著低于对照绀（P〈0．01），CD4／CD8显著高于对照组（P〈0．01）；术后第8天IL-10及TNF-仪显著高于对照组（P〈0．01），HLA．DR-淋巴细胞计数显著低于对照组（P〈0．05）。术后感染发生率鱼油组（16．7％）显著低于对照组（55．6％，P=0．035）。两组围术期死亡率和急性排斥反应发生率无显著性差异，但鱼油组术后重症监护时间和术后住院时间（分别为3．9±1．9、28．6±7．2d）显著短于对照组（分别为5．8±3．1、35．7±10．6d，P=0．034，P=0．024）。结论ω-3鱼油脂肪乳可纠正肝移植术后过度的炎症反应，恢复促炎／抗炎因子平衡，调整细胞免疫状态，降低感染发生率，改善预后。
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