Influence of n-3 fish oil fatty emulsion on fatty acid profile and inflammatory mediator in patients underwent total gastrectomy / 中国现代普通外科进展

ABSTRACT

Objective:To investigate the effects of n-3 fish oil fatty emulsion on fatty acid profile and lipid mediator,immune regulation mechanism and anti-inflammatory effect of inpatients underwent total gastrectomy.Methods:In a prospective,double-blind,and randomized controlled trial,60 patients underwent total gastrectomy were divided into two groups,therapy group and control group.The control group was given routine therapy while the therapy group was given routine therapy and fish oil.The day before the operation,1,4 and 8 days after the operation,The lipid metabolic Indices,including free fatty acids spectrum were detected;The inflammation indicator,including c-reactive protein(CRP) and interleukin(IL-1,lL-6),tumor necrosis factor alpha(TNF-α) were tested;The cellular immune function,including HLA-DR expression rate,the level of T cell subgroup were detected with flow cytometry.The clinical outcome indicators including APACHE Ⅱ score,postoperative infection and MODS incidence,postoperative hospitalization days,hospitalization mortality were observed.Results:There was no significant difference between Fish oil group and control group in age,sex and BMI,the serum levels of inflammatory cytokines,the HLA-DR expression rate,level of T cell subgroup,APACHE Ⅱ score,etc.(P＞0.05),so the two groups are comparable.Compared with control group,the n-6/n-3 PUFAs ratio drops,AA content decreased,but the content of EPA and DHA is increased,in fish oil group,decreased in fish oil group (P＜0.05);Compared with control group,serum concentration of CRP,IL-6 and TNF-α in patients of therapy group were significantly reduced,and clinical outcome improved.There was no difference in the expression of T cell subgroup between two groups.Conclusion:Application of n-3 fish oil fat emulsion,can lower the n-6/n-3 PUFAs ratio,reduce the AA content in serum,but the content of EPA and DHA is increased;N-3 fish oil fat emulsion can reduce serum after total gastrectomy,IL-1,IL-6,TNF-α inflammatory factor and the concentration of CRP,effectively reduce the inflammatory response in patients with;N-3 fish oil fat emulsion can improve the HLA-DR expression rate,reduce the immunosuppression,but had no significant effect on T cell subgroup level;N-3 fish oil fat emulsion to reduce the incidence of postoperative infection and MODS,improve patients with acute physiology,but had no significant effect on total days in hospital,mortality.