标题：ω3鱼油脂肪酸治疗脓毒症并肠功能障碍的疗效及其对患者免疫功能的影响

      作者：张华东 1，陈怀生 1，洪澄英 1，潘楚云 2
    (暨南大学第二临床医学院 深圳市人民医院重症医学科1、感染内科[肝病专科]2，广东 深圳 518020)

      卷次： 2015年26卷9期

      【摘要】 目的 探讨ω3鱼油脂肪酸能否通过改善淋巴细胞免疫功能来降低肠功能障碍患者的病死率。
方法 选择 48例存在肠功能障碍的严重脓毒症并多脏器功能障碍患者，随机将其为对照组与观察组，每组 24
例，对照组采用胸腺肽α1及乌司他丁等常规治疗，观察组在此基础上加用ω3鱼油脂肪酸治疗，比较两组患者的
死亡率、ICU住院日、急性生理与慢性健康评分(APACHEⅡ)、Marshall评分、T淋巴细胞亚群(CD3+、CD4+、CD8+及
CD4+/CD8+)及超敏C反应蛋白(hs-CRP)水平。结果 28 d随访中，对照组死亡10例，占41.7%，观察组死亡3例，
占12.5%，两组患者病死率比较差异有统计学意义(P<0.05)；观察组 ICU住院日短于对照组(P<0.05)；观察组治疗
第 7 d APACHEⅡ和Marshall评分均低于对照组，差异均有统计学意义(P<0.05)；观察组血清CD3+、CD4+、CD4+/
CD8+均明显高于对照组，hs-CRP低于对照组，差异均有统计学意义(P<0.05)。结论 ω3鱼油脂肪酸可能通过改
善淋巴细胞免疫功能从而降低肠功能障碍患者的病死率。

      【关键词】 脓毒症；多脏器功能障碍综合征；肠功能障碍；ω3鱼油脂肪酸

      【中图分类号】 R631+.2 【文献标识码】 A 【文章编号】 1003—6350（2015）09—1265—03


Efficacy of omega 3 fish oil in the treatment of sepsis patients with intestinal dysfunction and its effect on
immunological function.
ZHANG Hua-dong 1, CHEN Huai-sheng 1, HONG Cheng-ying 1, PAN Chu-yun 2. 1. Intensive
Care Unit 1, Infection in the Department of Internal Medicine (Hepatology) 2, the Second Affiliated Hospital of College of
Jinan University, Shenzhen People's Hospital, Shenzhen 518020, Guangdong, CHINA

【Abstract】 Objective To study the efficacy of omega 3 fish oil in reducing mortality in patients with intesti-
nal dysfunction by improving lymphocytes' immunological function. Methods Forty-eight patients with severe sep-
sis, multiple organ dysfunction syndrome (MODS) and intestinal dysfunction were recruited and randomly divided in-
to the control group and the treatment group, with 24 cases in each group. The control group was treated by thymosin α1,
ulinastatin and other conventional treatment, while the treatment group added omega 3 fish oil on the basis of the con-
trol group. The mortality, duration of mechanical ventilation, ICU stay days, and APACHEⅡ, Marshall score, T lym-
phocyte subsets (CD3+, CD4+, CD8+ and CD4+/CD8+) and hs-CRP levels were compared. Results During the 28-day fol-
low-up, 10 patients died in the control group (41.7%) and 3 patients died in the treatment group (12.5%), with statisti-
cally significant difference in the mortality between the two groups (P<0.05). Patients in treatment group had signifi-
cantly shorter ICU stay time (P<0.05). On the 7th day of treatment, APACHE Ⅱ and Marshall Scores in the treatment
group were all significantly lower than those in the control group (P<0.05). Besides, CD3 + , CD4 + , and the ratio of
CD4+/CD8+ were all significantly higher in treatment group than in control group, but hs-CRP levels were significantly
lower in the treatment group (P<0.05). Conclusion Omega 3 fish oil can reduce mortality in patients with intestinal
dysfunction by improving immunological function of lymphocytes.