ω-3多不饱和脂肪酸对急性呼吸窘迫综合征患者血清炎症介质的影响

目的观察ω-3多不饱和脂肪酸对急性呼吸窘迫综合征（ARDS）患者血清炎症介质释放的影响。方法将42例ARDS患者按随机化数字表原则,分为对照组和研究组,每组各21例。两组患者均接受等氮、等热量的全胃肠外营养,热量25kcal·kg^-1·d^-1、氮摄入量0.2g/kg,其中研究组加用ω-3多不饱和脂肪酸（0.2g·kg^-1·d^-1）,共7d。分别检测治疗前和治疗后第1、3、7天血清白细胞介素1（IL-1）、IL-6、肿瘤坏死因子α（TNF-α）水平,并观察动脉血氧分压和氧合指数的变化。结果加用ω-3多不饱和脂肪酸治疗后,研究组在不同时间点IL-1、IL-6、TNF-α均明显低于对照组（P均〈0.05）;两组患者动脉血氧分压和氧合指数均有改善,且研究组氧合指数较高,差异均有统计学意义（P均〈0.05）。结论ω-3多不饱和脂肪酸可降低ARDS患者IL-1、IL-6、TNF-α水平,在一定程度上有利于ARDS患者呼吸功能的恢复。

Effect of omega-3 polyunsaturated fatty acids on inflammatory mediators in patients with acute respiratory distress syndrome

Objective To investigate the effect of omega-3 polyunsaturated fatty acids on the release of serum inflammatory mediators in patients with acute respiratory distress syndrome(ARDS). Methods Forty-two patients with ARDS were randomly divided into control and research groups, 21 in each. All the patients were given total parenteral nutrition including equal nitrogen (0.2 g / kg) and calorie (25 kcal·kg-1·d-1), while in the research group patients are given extra omega-3 polyunsaturated fatty acids (0.2 g·kg-1·d-1) for 7 d. The levels of serum interleukin-1 (IL-1), IL-6 and tumor necrosis factor-alpha (TNF-α) were detected both before treatment and on the 1st, 3th, 7th d after the treatment, respectively. The changes of arterial partial pressure of oxygen and oxygenation index were also observed. Results The levels of IL-1, IL-6 and TNF-α in the research group were all significantly lower than the control group at different time points (all P < 0.05). After the treatment, the arterial partial pressure of oxygen and oxygenation index in the two groups were all improved, and in the research group oxygenation index were much higher (all P < 0.05). Conclusion Omega-3 polyunsaturated fatty acids can reduce the expression of IL-1, IL-6 and TNF-α, which to a certain extent, is beneficial to the recovery of respiratory function in patients with ARDS.