Abstract: 【Abstract】 Objective To investigate the effect of ω-3 fish oil emulsion on intestinal permeability and bacterial translocation. Methods Ninety patients with intestinal obstruction were randomized into treatment group and controls. Controls received conventional treatment, including fasting, gastrointestinal decompression, correcting water electrolyte and acid-base balance disorders, parenteral nutrition and antibiotics. Treatment group used ω-3 fish oil emulsion on the basis of conventional therapy. Peripheral blood were collected for detection of routine serum biochemical, plasma glutamate (Gln) concentration and bacterial DNA. Meanwhile, urinary lactulose/mannitol (L/M) ratio was measured. The indexes above were compared between two groups. Results Serum albumin, serum prealbumin, serum transferrin in both groups increased higher significantly (P<0.05) while blood glucose was obviously lower (P<0.05). In the control group, IgA of the late course decreased sharply than the earlier(P<0.05), but there was no significant change in the treatment group. Plasma ω-3 fish oil emulsion concentrations in the treatment group was higher (P<0.01) than the control group,but the urinary lactulose/mannitol (L/M) ratio in the late course and the positive rate of bacterial DNA in peripheral blood were lower than that in control group (P<0.01). Conclusions ω-3 fish oil emulsion plays an important role in maintaining gut barrier function in patients with intestinal obstruction, at the same time, it can reduce bacterial translocation and complications.

Key words: ω-3 fish oil emulsion, Intestinal obstruction, Intestinal permeability, Bacterial translocation

摘要： 【摘要】 目的 ω-3鱼油脂肪乳剂对其肠粘膜通透性及细菌移位的影响。 方法 90例肠梗阻患者随机分为治疗组和对照组。对照组按照常规治疗方法,如禁食、胃肠减压、全胃肠外营养、应用抗生素以及纠正水电解质和酸碱平衡紊乱。治疗组在对照组的基础上加用ω-3鱼油脂肪乳剂。检测比较两组病例入院时、治疗后第3日、第7日的常规指标、免疫学指标,采集两组患者外周血进行血浆谷氨酞胺(Gln)浓度和全血细菌DNA检测,同时进行尿中乳果糖/甘露醇(L/M)比值测定。 结果ω-3鱼油脂肪乳剂治疗组血糖升高幅度明显降低(P<0.05),血清白蛋白(ALB)、血清前白蛋白(PA)、血清转铁蛋白(TF)恢复性升高(P<0.05);早期IgA水平较对照明显增高(P<0.05)。另外对照组尿乳果糖/甘露醇(L/M)比值、外周血中细菌DNA阳性率高于治疗组(P<0.01),而血浆谷氨酰胺浓度低于治疗组(P<0.01)。 结论 ω-3鱼油脂肪乳剂使用具有维护肠梗阻患者肠粘膜屏障功能、减少细菌移位、减少并发症起着重要的作用。

关键词: ω-3鱼油脂肪乳剂;肠梗阻;肠粘膜通透性;菌群移位