JGH: Omega-3 脂肪酸乳剂可安全有效地减少急性慢性肝衰竭中的内毒素血症和败血症

2021-07-18 MedSci原创 MedSci原创

急性慢性肝功能衰竭 (ACLF) 是一种急性病症,具有高发病率和死亡率。即使没有全身炎症反应综合征 (SIRS),28天死亡率依然可以高达6-18%。

      急性慢性肝功能衰竭 (ACLF) 是一种急性病症,具有高发病率和死亡率。即使没有全身炎症反应综合征 (SIRS),28天死亡率依然可以高达6-18%。虽然肝移植是 ACLF 的绝佳治疗选择,但是并不是所有患者均有机会接受肝移植。脓毒症是急性加慢性肝衰竭 (ACLF) 患者预后的重要决定因素。众所周知,Omega-3 脂肪酸 (FA) 可以抑制术后和危重患者的炎症、降低发病率和死亡率。本项研究旨在评估静脉注射 omega-6 和 omega-3 FA 脂质乳剂对 ACLF 患者的影响。

 

       在本项研究中90 名 ACLF 患者被随机分配到三组:A:没有接受脂质乳剂,B: 接受了 omega-6 脂肪酸,C: 接受了 omega-3 脂肪酸。主要和次要观察目的是比较脂质乳剂对免疫调节、细菌性败血症发生率和第 28 天死亡率的差异。

 

       在接受了 omega-3 脂肪酸治疗的ACLF患者中血清内毒素水平被抑制了 22%。而A:没有接受脂质乳剂和B: 接受了 omega-6 脂肪酸的患者中内毒素分别增长 4% 和 12%,( P< 0.001)。Omega-3 FA 还抑制患者的C 反应蛋白水平和中性粒细胞与淋巴细胞的比率。A,omega-3 FA 将败血症减少了 86%(HR,0.14;95% CI 0.04–0.43;P  < 0.001)。Omega-3 FA 显着增加了 CD14 +和 CD16 +单核细胞上 TLR2 和 TLR4 的表达,以及巨噬细胞和中性粒细胞上TLR4 的表达。

 

      本项研究证实Omega-3 FA 可安全有效地减少 ACLF 患者的全身炎症、内毒素血症和败血症。这些脂质乳剂也可以被认为是此类患者免疫营养的有效来源。

 

 

原始出处:

Anand V Kulkarni. Et al. Omega-3 fatty acid lipid emulsions are safe and effective in reducing endotoxemia and sepsis in acute-on-chronic liver failure: An open-label randomized controlled trial. Journal of Gastroenterology and Hepatology.2021.

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    2021-07-18 147c3b86m51暂无昵称

    有帮助

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    2021-07-18 刘惠娇

    学习了

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