ω-3多不饱和脂肪酸对危重症肠外营养病人凝血系统和炎性反应的影响

目的:观察ICU肠外营养病人凝血因子和炎性因子的变化以及ω-3多不饱和脂肪酸对活化激活的凝血因子、炎性因子的调控作用。方法:将30例需PN的危重症病人随机分为常规组和尤文组,连续3 d给予PN。分别检测两组治疗前和治疗后1、2和3 d血浆NF-κB、6-酮-前列腺素F1α、E-选择素、可溶性细胞间黏附分子、凝血酶-抗凝血酶复合物、凝血酶原片段F1+2、D-二聚体、血栓调节素等水平。结果:常规组病人营养支持后与营养支持前比较,血浆NF-κB、可溶性细胞间黏附分子、E-选择素水平明显增加(P0.05)。血浆6-酮-前列腺素F1α水平明显下降(P0.05)。尤文组营养支持后与支持前比较,血浆NF-κB、可溶性细胞间黏附分子、E-选择素水平明显下降(P0.05),血浆6-酮-前列腺素F1α均明显增加(P0.05)。常规组营养支持后与营养支持前比较,血浆血栓调节素、凝血酶原片段F1+2、凝血酶-抗凝血酶复合物和D-二聚体明显增加(P0.05)。尤文组营养支持后与营养支持前比较,血浆血栓调节素、凝血酶原片段F1+2、凝血酶-抗凝血酶复合物及D-二聚体明显降低(P0.05)。结论:ω-3多不饱和脂肪酸具有抑制炎性反应,改善凝血紊乱的作用。

Effect of Omegaven on blood clotting system and inflammatory reaction in ICU patients with parenteral nutrition

Objective: To observe the changes of blood coagulation factors and inflammatory factors and the regulatin effect of Omegaven.Methods: Thirty ICU patients were randomly allocated into two groups: Omegaven group and control group.Serum concentrations of NF-κB、PGF1α、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 were measured before and after parenteral nutrition.Results: Patients in control group had significantly higher NF-κB、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 concentration,lower PGF1α concentration.Patients treated with Omegaven had significantly lower NF-κB、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 concentration,higher PGF1α concentration.Conclusion: Omegaven can suppress inflammatory reaction and improve coagulopathy.