劉流 1 , 莊文 1 , 陳忠 2
  • 1.四川大學(xué)華西醫(yī)院胃腸外科中心（成都　610041）;;
  • 2.四川大學(xué)華西第二醫(yī)院兒科（成都　610041）;

目的  研究ω-3多不飽和脂肪酸對胃腸道惡性腫瘤患者術(shù)后炎癥反應(yīng)和營養(yǎng)狀態(tài)的影響。方法  將華西醫(yī)院胃腸外科中心2009年2月1日至6月1日收治的40例胃腸道惡性腫瘤患者隨機分為對照組和實驗組各20例。術(shù)后2組連續(xù)行7 d腸外營養(yǎng)支持治療,實驗組每天加用ω-3多不飽和脂肪酸10 g。術(shù)前、術(shù)后第2天及術(shù)后第8天分別抽血檢測炎癥反應(yīng)指標(包括白細胞、中性粒細胞和C反應(yīng)蛋白水平)和營養(yǎng)狀態(tài)指標(包括總蛋白、白蛋白、前白蛋白、轉(zhuǎn)鐵蛋白和淋巴細胞水平)以及手術(shù)前、后體重變化(體重差)。結(jié)果  2組患者的基線一致，具有可比性(P gt;0.05)。術(shù)后第2天2組患者各項炎癥反應(yīng)指標和營養(yǎng)狀態(tài)指標水平比較，差異均無統(tǒng)計學(xué)意義(P gt;0.05)； 至術(shù)后第8天，實驗組的中性粒細胞和C反應(yīng)蛋白水平均明顯低于對照組，淋巴細胞水平明顯高于對照組，差異有統(tǒng)計學(xué)意義(P lt;0.05)。2組患者的體重差比較差異無統(tǒng)計學(xué)意義(P gt;0.05)。結(jié)論  ω-3多不飽和脂肪酸能夠有效減輕胃腸道惡性腫瘤患者術(shù)后的炎癥反應(yīng)，改善患者的術(shù)后營養(yǎng)狀態(tài)。

引用本文： 劉流,莊文,陳忠. ω-3多不飽和脂肪酸對胃腸道惡性腫瘤患者術(shù)后炎癥反應(yīng)和營養(yǎng)狀態(tài)的影響. 中國普外基礎(chǔ)與臨床雜志, 2009, 16(12): 964-967. doi: 復(fù)制

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9. 賈云鶴, 江志偉, 佴永軍, 等. 胃癌術(shù)后感染和排空障礙與術(shù)前營養(yǎng)不良及營養(yǎng)指標的相關(guān)研究 [Ｊ]. 腸外與腸內(nèi)營養(yǎng), 2005； 12(3)： 143-145.
10. Evangelista V, Dell’Elba G, Celardo A, et al. TxA2-mediated myocardial ischemia as a consequence of an acute lung inflammatory reaction in the rabbit [Ｊ]. J Thromb Haemost, 2003; 1(2): 314-319.
11. Wu GH, Zhang YW, Wu ZH. Modulation of postoperative immune and inflammatory response by immune-enhancing enteral diet in gastrointestinal cancer patients [Ｊ]. World J Gastroenterol, 2001; 7(3): 357-362.
12. Lin MT, Yeh SL, Yeh CL, et al. Parenteral ω-3 fatty acids modulate inflammatory and immune response in rats undergoing total gastrectomy [Ｊ]. Shock, 2006; 25(1): 56-60.
13. Calder PC. ω-3 polyunsaturated fatty acids and inflammation: from molecular biology to the clinic [Ｊ]. Lipids, 2003; 38(4): 343-352.
14. Calder PC. ω-3 polyunsaturated fatty acids and cytokine production in health and disease [Ｊ]. Ann Nutr Metab, 1997; 41(4): 203-234.
15. Li Q, Wang M, Tan L, et al. Docosahexaenoic acid changes lipid composition and interleukin-2 receptor signaling in membrane rafts [Ｊ]. J Lipid Res, 2005; 46(9): 1904-1913.
16. Huber TB, Simons M, Hartleben B, et al. Molecular basis of the functional podocin-nephrin complex: mutations in the NPHS2 gene disrupt nephrin targeting to lipid raft microdomains [Ｊ]. Hum Mol Genet, 2003; 12(24): 3397-3405.
17. Zhao Y, Joshi-Barve S, Barve S, et al. Eicosapentaenoic acid prevents LPS-induced TNF-α expression by preventing NF-κB activation [Ｊ]. J Am Coll Nutr, 2004; 23(1): 71-78.
18. Li H, Ruan XZ, Powis SH, et al. EPA and DHA reduce LPS-induced inflammation responses in HK-2 cells: evidence for a PPAR-gamma-dependent mechanism [Ｊ]. Kidney Int, 2005; 67(3): 867-874.
19. 王新穎, 李維勤, 李寧, 等. ω-3多不飽和脂肪酸對重癥急性胰腺炎病人早期炎性反應(yīng)的影響 [Ｊ]. 腸外與腸內(nèi)營養(yǎng), 2008； 15(4): 214-217.
20. Tsekos E, Reuter C, Stehle P, et al. Perioperative administration of parenteral fish oil supplements in a routine clinical setting improves patient outcome after major abdominal surgery [Ｊ]. Clin Nutr, 2004; 23(3): 325-330.
21. Heys SD, Walker LG, Smith I, et al. Enteral nutritional supplementation with key nutrients in patients with critical illness and cancer: a meta-analysis of randomized controlled clinical trials [Ｊ]. Ann Surg, 1999; 229(4): 467-477.
22. 劉流， 莊文， 陳忠. ω-3不飽和脂肪酸促進胃腸道惡性腫瘤患者術(shù)后康復(fù)的療效研究 [Ｊ]. 中國普外基礎(chǔ)與臨床雜志，2009； 16(11): 895-899.
  1. 1. Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002 [Ｊ]. CA Cancer J Clin, 2005; 55(2): 74-108.
  2. 2. Boyle P, Leon ME. Epidemiology of colorectal cancer [Ｊ]. Br Med Bull, 2002; 64: 1-25.
  3. 3. Jeschke MG, Klein D, Herndon DN. Insulin treatment improves the systemic inflammatory reaction to severe trauma [Ｊ]. Ann Surg, 2004; 239(4): 553-560.
  4. 4. 任成山， 陸海華, 杜曉鋒， 等. 重度創(chuàng)傷后全身炎癥反應(yīng)綜合征和多器官功能障礙綜合征 [Ｊ]. 中國危重病急救醫(yī)學(xué), 2001； 13(11): 690-693.
  5. 5. Richards GA. Lipid nutrients in critical illness [Ｊ]. Clin Pulm Med， 2009； 16(5): 265-269.
  6. 6. Pacht ER. Enteral therapy to decrease morbidity and improve survival in acute respiratory distress syndrome: its time has come [Ｊ]. Crit Care Med, 2006; 34(9): 2492-2493.
  7. 7. 黃莚庭. 大腸癌診治現(xiàn)狀與展望 [Ｊ]. 中國普外基礎(chǔ)與臨床雜志, 2000； 7(1): 44-45.
  8. 8. 陳威佐, 陳文元, 羅好曾. 武威市2001~2005 年胃癌發(fā)病率分析 [Ｊ]. 中國腫瘤, 2007； 16(5): 309-310.
  9. 9. 賈云鶴, 江志偉, 佴永軍, 等. 胃癌術(shù)后感染和排空障礙與術(shù)前營養(yǎng)不良及營養(yǎng)指標的相關(guān)研究 [Ｊ]. 腸外與腸內(nèi)營養(yǎng), 2005； 12(3)： 143-145.
  10. 10. Evangelista V, Dell’Elba G, Celardo A, et al. TxA2-mediated myocardial ischemia as a consequence of an acute lung inflammatory reaction in the rabbit [Ｊ]. J Thromb Haemost, 2003; 1(2): 314-319.
  11. 11. Wu GH, Zhang YW, Wu ZH. Modulation of postoperative immune and inflammatory response by immune-enhancing enteral diet in gastrointestinal cancer patients [Ｊ]. World J Gastroenterol, 2001; 7(3): 357-362.
  12. 12. Lin MT, Yeh SL, Yeh CL, et al. Parenteral ω-3 fatty acids modulate inflammatory and immune response in rats undergoing total gastrectomy [Ｊ]. Shock, 2006; 25(1): 56-60.
  13. 13. Calder PC. ω-3 polyunsaturated fatty acids and inflammation: from molecular biology to the clinic [Ｊ]. Lipids, 2003; 38(4): 343-352.
  14. 14. Calder PC. ω-3 polyunsaturated fatty acids and cytokine production in health and disease [Ｊ]. Ann Nutr Metab, 1997; 41(4): 203-234.
  15. 15. Li Q, Wang M, Tan L, et al. Docosahexaenoic acid changes lipid composition and interleukin-2 receptor signaling in membrane rafts [Ｊ]. J Lipid Res, 2005; 46(9): 1904-1913.
  16. 16. Huber TB, Simons M, Hartleben B, et al. Molecular basis of the functional podocin-nephrin complex: mutations in the NPHS2 gene disrupt nephrin targeting to lipid raft microdomains [Ｊ]. Hum Mol Genet, 2003; 12(24): 3397-3405.
  17. 17. Zhao Y, Joshi-Barve S, Barve S, et al. Eicosapentaenoic acid prevents LPS-induced TNF-α expression by preventing NF-κB activation [Ｊ]. J Am Coll Nutr, 2004; 23(1): 71-78.
  18. 18. Li H, Ruan XZ, Powis SH, et al. EPA and DHA reduce LPS-induced inflammation responses in HK-2 cells: evidence for a PPAR-gamma-dependent mechanism [Ｊ]. Kidney Int, 2005; 67(3): 867-874.
  19. 19. 王新穎, 李維勤, 李寧, 等. ω-3多不飽和脂肪酸對重癥急性胰腺炎病人早期炎性反應(yīng)的影響 [Ｊ]. 腸外與腸內(nèi)營養(yǎng), 2008； 15(4): 214-217.
  20. 20. Tsekos E, Reuter C, Stehle P, et al. Perioperative administration of parenteral fish oil supplements in a routine clinical setting improves patient outcome after major abdominal surgery [Ｊ]. Clin Nutr, 2004; 23(3): 325-330.
  21. 21. Heys SD, Walker LG, Smith I, et al. Enteral nutritional supplementation with key nutrients in patients with critical illness and cancer: a meta-analysis of randomized controlled clinical trials [Ｊ]. Ann Surg, 1999; 229(4): 467-477.
  22. 22. 劉流， 莊文， 陳忠. ω-3不飽和脂肪酸促進胃腸道惡性腫瘤患者術(shù)后康復(fù)的療效研究 [Ｊ]. 中國普外基礎(chǔ)與臨床雜志，2009； 16(11): 895-899.