The effect of ω-3 fatty acids immune-nutrition therapy on immunological function in patients with acute ischemic stroke

Abstract

Objective To explore the effect of ω-3 fatty acids(ω-3PUFA)immune-nutrition therapy onimmunological function in the patients with acute ischemic stroke and to analyze its mechanism. Methods Totally 42 patients with acute ischemic stroke were selected from August 2015 to February 2016.They were divided into the treatment group(n=23)and the control group(n=19). The patients were given indwelling tube within 24 hours after being admitted to hospital, followed by giving the hospital self-made homogenized meal in control group and ω-3PUFA enteral nutrition in treatment group.The variables of C reactive protein(CRP), High sensitive C reactive protein(hsCRP), immunoglobulin A(IgA), immunoglobulin M(IgM), immunoglobulin G(IgG), T-cell subsets, total lymphocytes were measured before and days 7, 14 and 21 after treatment.The changes of index and the incidence rate of infection complications were valuated.The NIHSS score, Glasgow coma scale(GCS)score, and modified RANKIN scales(mRS)score were compared between the two groups before and after treatment, and the clinical curative effect was observed. Results Compared with the control group, the immunotherapy group showed that the C reactive protein and high sensitive C reactive protein were decreased faster and more, with significant difference(P<0.05). The levels of immunoglobulin A(IgA), immunoglobulin M(IgM), immunoglobulin G(IgG), LY and cell counts of CD3+ , CD4+ T-cell subsets at 21 days of the treatment were significantly higher in the immune-therapy group than in the control group〔(3.1±0.7 vs.2.5±0.9)g/L, (1.2±0.3 vs.1.0±0.2)g/L, (12.8±2.2 vs.11.1±2.9)g/L, (1.7±0.4 vs.1.4±0.4)×109/L, (1.2±0.31 vs.1.0±0.2)×109/L, (0.8±0.2 vs.0.6±0.1)×109/L〕. The above differences were statistical significant(t=2.28, 2.43, 2.21, 2.60, 2.57, and 2.73, each P<0.05). The difference in CD8+ T cell subset count between pre-and post-treatment was more obvious in the treatment group than in the control group, with statistical significance(t=2.64, P=0.01). The incidence rate of infection complications was 34.8% in the treatment group, and 94.7% in the control group, with statistical significance(χ2=15.89, P<0.001). After 21 days of treatment, the NIHSS score, GCS score and mRS score were significantly better in the immune therapy group than in the control group(8.7±5.2 vs.14.3±4.8, 14.7±0.7 vs.13.1±1.7, 3.1±1.0 vs.4.1±0.4), with statistical significance(t=-4.79, 3.07 and-3.05, P<0.01). Conclusions Immune nutrition with Omega-3 fatty acid improves not only the humoral immune function, but also the cellular immune function in patients with ischemic stroke.It decreases the infection rate and improves the prognosis of patients after stroke. Key words: Fatty acids, ω-3; Enteral nutrition; Stroke; Immunity