Effects of ω-3 fish oil emulsion on systemic inflammatory response syndrome in the early phase of severe acute pancreatitis:randomized clinical trial for 60 patients

Abstract

Objective To evaluation the effects of parenteral supplementation with ω-3 fish oil emulsion on the systemic inflammatory response syndrome(SIRS)in the early phase of severe acute pancreatitis(SAP).Methods Sixty patients with SAP were randomized either to treat with fish oil emulsion 0.2 g/(ks·d)(FO group,n=30)or conventional therapy(Con group,n=30),and the change of SIRS state were observed by acute physiology and chronic health evaluation Ⅱ(APACHE-Ⅱ)scores,SIRS scores,and inflammatory cytokines.Results During observation,APACHE-Ⅱ scores in FO group were significantly lower,and the gap increased even larger after Day 4(P＜0.05).The negative fluid equilibrium time significantly decreased in FO group[(5.1±2.2)days]compared with Con group[(8.4±2.3)days](P＜0.05),while SIRS scores significantly decreased and firstly went out the SIRS state on Day 4 after treatment.Compared with Con group,the plasma level of tumor necrosis factor-α(TNF-α)continuously significantly decreased,interleukin-10(IL-10)significantly increased,and the ratio of IL-10/TNF-α significantly increased,which was most remarkable between Day 4 and Day 7 aftertreatment in FO group(P＜0.05).Conclusions Early parenteral supplementation with ω-3 fish oil emulsion can effectively reduced the magnitude and persistence of the SIRS,retrieve the unbalance of the pro-/anti-inflammatory,and improve the severe disease conditions.Therefore,it provides a new and feasible way to reglate SIRS in the early phase of SAP. Key words: Severe acute pancreatitis; Systemic inflammatory response syndrome; ω-3 fish oil emulsion