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目的:观察添加鱼油的肠外营养(PN)对重症急性胰腺炎(SAP)病人免疫功能和临床预后的影响。方法:将56例SAP病人随机分为研究组和对照组,每组28例。使用等氮、等热量PN共5 d,其中非蛋白质热量为112.9 kJ/(kg.d)、氮量为0.2 g/(kg.d)。对照组病人用中长链脂肪乳剂,研究组病人用鱼油+中长链脂肪乳剂。分别在试验开始前和试验第6天早晨,抽取静脉血检测人类主要组织相容性抗原DR(HLA-DR)、白细胞分化抗原、CD4/CD8比值和IL-10水平等,同时记录感染发生率和手术比率。结果:添加鱼油的PN能明显增加SAP病人IL-10水平,改善HLA-DR表达。研究组病人感染发生率和手术比率均有下降。结论:添加鱼油的PN能明显改善SAP病人的免疫功能,降低感染和手术风险。
Objective: To observe the effects of parenteral nutrition (PN) supplemented with fish oil on immune function and clinical prognosis in patients with severe acute pancreatitis (SAP). Methods: 56 cases of SAP patients were randomly divided into study group and control group, 28 cases in each group. Nitrogen was used, and the isothermal calorie PN was 5 d, of which the non-protein calorie was 112.9 kJ / (kg · d) and the nitrogen content was 0.2 g / (kg · d). Control group of patients with long-chain fat emulsion, the study group of patients with fish oil + long-chain fat emulsion. Blood samples of human major histocompatibility antigen DR (HLA-DR), leukocyte differentiation antigen, CD4 / CD8 ratio, and IL-10 levels were collected before the start of the experiment and on the morning of the sixth day of the experiment. The incidence of infection And surgery rate. Results: Adding fish oil PN significantly increased the level of IL-10 in SAP patients and improved HLA-DR expression. Study group patients with infection rates and surgical rates have decreased. Conclusion: The addition of fish oil PN can significantly improve the immune function of patients with SAP, reduce the risk of infection and surgery.