[1]张军,孙士锦,张宏光,等.多发伤患者细胞免疫功能的变化及加鱼油肠外营养对其的影响[J].陆军军医大学学报(原第三军医大学学报),2009,31(05):446-449.
　ZHANG Jun,SUN Shi-jin,ZHANG Hong-guang,et al.Changes of cellular immune function in multiple trauma patients and effect of fish oil parenteral nutrition[J].J Amry Med Univ (J Third Mil Med Univ),2009,31(05):446-449.
点击复制

多发伤患者细胞免疫功能的变化及加鱼油肠外营养对其的影响(/HTML )
分享到：

陆军军医大学学报（原第三军医大学学报）[ISSN:1000-5404/CN:51-1095/R]

卷:
31卷
期数:
2009年第05期
页码:
446-449
栏目:
论著
出版日期:
2009-03-15

文章信息/Info

Title:
Changes of cellular immune function in multiple trauma patients and effect of fish oil parenteral nutrition
作者:
张军; 孙士锦; 张宏光; 姚元章; 蒋东波; 周健; 梁华平; 张连阳
第三军医大学大坪医院野战外科研究所：创伤外科，全军战创伤中心，第一研究室，创伤、烧伤与复合伤国家重点实验室
Author(s):
ZHANG Jun;  SUN Shi-jin;  ZHANG Hong-guang;  YAO Yuan-zhang;  JIANG Dong-bo;  ZHOU Jian;  LIANG Hua-ping;  ZHANG Lian-yang
Trauma Centre, State Key Laboratory of Trauma, Burns and Combined Injury, Department 1, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing 400042, China
关键词:
ω-3多聚不饱和脂肪酸; 肠外营养; 多发伤; C-反应蛋白; 移动抑制因子; 干扰素-γ; 白介素-4
Keywords:
ω-3 polyunsaturated fatty acids;  parenteral nutrition;  multiple trauma;  C-reactive protein;  macrophage migration inhibitory factor;  interferon-γ;  interleukin-4
分类号:
R392.12；R459.3；R605.979
文献标志码:
A
摘要:
目的    探讨多发伤后细胞免疫功能的变化及加鱼油肠外营养对多发伤患者的影响。    方法    2007年8月至2008年3月本中心收治的26例多发伤患者随机分为鱼油组和常规组，入院后即按等氮等热量的肠外营养方式给药：常规组脂肪采用大豆油1.2 g·kg-1·d-1，鱼油组脂肪采用大豆油1.0 g·kg-1·d-1加鱼油0.2 g·kg-1·d-1，均连续使用5 d。于入院后及治疗后第3、6天采集患者外周静脉血，ELISA法检测CRP、MIF、IFN-γ及IL-4浓度。    结果    多发伤患者外周血中CRP、MIF、IL-4水平均较对照组升高非常显著(P<0.01)，IFN-γ水平较对照组降低非常显著(P<0.01)；治疗后第3天，鱼油组CRP、IL-4水平较常规组显著降低(P<0.05)，MIF水平较常规组降低非常显著(P<0.01)，IFN-γ水平较常规组显著升高(P<0.05)；治疗后第6天，鱼油组CRP、IL-4水平均较常规组降低非常显著(P<0.01)，IFN-γ水平较常规组升高非常显著(P<0.01)。    结论    常规治疗的同时，补充ω-3 PUFAs可以显著改善多发伤患者机体免疫防御，有效抑制了Th1/Th2应答模式的偏移，降低了多发伤后过度的炎症反应程度，对提高多发伤患者的救治具有重要意义。
Abstract:
Objective    To observe the changes of cellular immune function on multiple trauma patients and the effects of fish oil parenteral nutrition on these changes.     Methods    Totally 26 patients of multiple trauma were randomly and equally divided into fish oil group (mainly containing ω-3 polyunsaturated fatty acids) and conventional group. Another 20 health individuals served as control. Besides regular management, conventional group was given parenteral nutrition  with soybean oil 1.2 g·kg-1·d-1, fish oil group with soybean oil 1.0 g·kg-1·d-1 and fish oil 0.2 g·kg-1·d-1 for 5 d. Collection of peripheral blood before treatment and 3 and 6 d after treatment respectively. Serum concentration of C-reactive protein (CRP), macrophage migration inhibitory factor (MIF), IFN-γ and IL-4 were measured with ELISA.     Results    Serum concentration of CRP, MIF and IL-4 levels were significantly higher in multiple trauma patients than the control group (P<0.01), IFN-γ level was significantly lower (P<0.01). From t the 3rd day after treatment, the fish oil group had significantly lower levels of CRP and IL-4 (P<0.05), and very significantly lower MIF than the conventional group (P<0.01), while that of IFN-γ level was significantly higher in the former than the later group (P<0.05); at the 6th day after treatment, the CRP, MIF, IL-4 levels of fish oil group was very significant lower than the conventional group (P<0.01), and IFN-γ level very significant higher(P<0.01).     Conclusion    ω-3 polyunsaturated fatty acids can be regarded a helpful supplementation for regular management for multiple trauma, which significantly improves immune defense by effectively suppressing the Th1/Th2 response patterns shift and reducing secondary injuries after excessive inflammatory response.

相似文献/References:

[1]马正伟,刘利东,李昆,等.肝移植大鼠肠外营养模型的建立与评价[J].陆军军医大学学报(原第三军医大学学报),2004,26(22):0.[doi:10.16016/j.1000-5404.2004.22.029 ]
　MA Zheng-wei,LIU Li-dong,LI Kun,et al.[J].J Amry Med Univ (J Third Mil Med Univ),2004,26(05):0.[doi:10.16016/j.1000-5404.2004.22.029 ]
[2]宋娟,张超.28例小肠瘘患者完全胃肠外营养的护理[J].陆军军医大学学报(原第三军医大学学报),2004,26(22):0.[doi:10.16016/j.1000-5404.2004.22.041 ]
[3]胡虞乾,廖文胜,杨威,等.高龄梗阻性黄疸患者术后早期肠内营养的研究[J].陆军军医大学学报(原第三军医大学学报),2005,27(18):1904.
[4]闫军,卢倩,董家鸿,等.肝功能损害病人术后早期肠内营养疗效观察[J].陆军军医大学学报(原第三军医大学学报),2004,26(12):0.[doi:10.16016/j.1000-5404.2004.12.032 ]
　YAN Jun,LU Qian,DONG Jia hong.[J].J Amry Med Univ (J Third Mil Med Univ),2004,26(05):0.[doi:10.16016/j.1000-5404.2004.12.032 ]
[5]陈忠勇,汪仕良,余斌,等.严重烧伤后营养支持途径对机体肠道功能的影响[J].陆军军医大学学报(原第三军医大学学报),2000,22(03):0.[doi:10.16016/j.1000-5404.2000.03.001 ]
　CHEN Zhong yong,WANG Shi liang,YU Bin,et al.[J].J Amry Med Univ (J Third Mil Med Univ),2000,22(05):0.[doi:10.16016/j.1000-5404.2000.03.001 ]
[6]骆文君,李春花,林辉,等.营养支持在妊娠合并急性胰腺炎中的应用及疗效初步评价[J].陆军军医大学学报(原第三军医大学学报),2017,39(13):1400.
　LUO Wenjun,LI Chunhua,LIN Hui,et al.Application and preliminary evaluation of nutritional support in acute pancreatitis of pregnancy[J].J Amry Med Univ (J Third Mil Med Univ),2017,39(05):1400.

更新日期/Last Update: 2009-03-12