中文摘要：

目的探讨添加鱼油脂肪乳的全胃肠外营养（TPN）对脓毒症患者细胞免疫功能及炎性反应的影响。方法40例脓毒症患者分为A、B两组，各20例。两组患者均接受等氮、等热量的TPN，B组加用ω-3鱼油脂肪乳1—2ml／（kg·d）。用流式细胞仪检测外周血CD4^＋；CD25^＋Treg、CD4^＋和CD4^＋细胞及CD4^＋／CD8^＋比值，采用ELISA法检测血TNF-α、IL-10和IL-10／TNF-α。结果B组患者治疗后与A组比较，CD8^＋、CD4^＋CD25^＋Treg细胞比例显著降低（P均〈0．05），CD4^＋、CD4^＋／CD8^＋明显升高（P均〈0．05）。血浆TNF-α和IL-10水平及均IL-10／TNF-α均明显降低（P均〈0．05）。随访28d，A组2例、B组4例死亡，两组相比P〉0．05。结论ω-3鱼油脂肪乳增强脓毒症患者机体免疫功能，调节促、抗炎因子的平衡。

英文摘要：

Objective To evaluate the effect of total parenteral nutrition added with ω-3 fish oil fat emulsion on the cell immunological function and inflammatory response in patients with severe sepsis. Method 40 patients with severe sepsis were randomly divided into routine total parenteral nutrition （TPN） group （group A, 20 cases） and ω-3 fish oil fat emulsion ＋ TPN treatment group （ group B, 20 cases）. Patients in group A received routine TIN, and patients in group B received TPN with ω-3 fish oil fat emulsion 1 -2 ml/（ kg · d ）. The blood samples of the patients were abstracted before the treatment and the 6 th day after the treatment respectively. CD4^＋CD25^＋ Treg ,the proportion of CD; ceil, CD8^＋ cell, CD4^＋ CD25^＋Treg cell in the total lymphoeytes were measured by flow eytometry. The concentration of IL-10 and TNF-α were detected by ELISA. Result Compared with group A, the proportion of CD4^＋ CD25^＋ Treg,the concentration of IL-10 and TNF-α ,the ratio of TNFF-α /IL-10 fell markedly,and the ratio of CD4^＋/CD8 rose markedly in group B （ P 〈0.01 ） after the treatment. The fatality rate of group B was lower than group A in 28 d, but the difference was not significant （ P 〉 0.05 ）. Conclusion ω-3 fish oil fat emulsion can regulate and enhance the organism immunological function of the patients with severe sepsis, regulate the balance of pro- and anti- inflammatory factor.