碩士 / 中國文化大學 / 生活應用科學研究所 / 93 / Sepsis is one of the major causes of patients death in intensive care units. There are great improvements in critical care medicine, but the mortality of patients with septic shock responses is still high. The mortality rate is about 46%~82%. The septic shock responses including fever, hypotension, disseminated intravascular coagulation (DIC), and damage that can lead to multiple organ failure (MOF). DIC is a systemic syndrome of septic shock characterized by enhanced activation of coagulation with some intravascular fibrin formation and deposition. Pathologic studies have demonstrated the presence of intravascular fibrin in tissues of patients who had died from an illness associated with evidence of DIC. Furthermore, experimental studies have demonstrated that effective inhibition of DIC can indeed reduce mortality. Therefore, prevention or management of coagulopathy response is one of important issues of in critical care of septic subjects.
In recent years, there were several studies demonstrated fish oil supplement might reduce blood lipid content of hyperlipidemia individuals. Fish oil supplement also inhibited blood coagulation and thrombus formation, and then reduced the risk of cardio vascular diseases. Furthermore, both of basic and clinical studies revealed that total parenteral supplementation with fish oil emulsion may reduce the inflammatory responses of septic individuals. However, there is no study to investigate the effects of dietary fish oil supplement on coagulopathy response and organ dysfunction of septic individuals. We plan to investigate these problems.
In study, male SD (Sprague-Dawley) rats were orally supplemented with normal saline, fish oil, safflower seed oil or coconut oil for 30 days, at the dosage of 4 ml/kg body weight / day. In the end of supplementation, we measured coagulation parameters including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and d-dimer level. Our results showed that there were no differences in coagulation parameters among saline, fish oil, safflower seed oil and coconut oil supplement groups. We also measured serum alanine transaminase (ALT) and total bilirubin (TBIL) levels for hepatic function evaluation, and blood urea nitrogen (BUN), creatinine (CRE) levels for renal function evaluation. Serum biochemistry data showed that hepatic and renal function of all experimental groups are normal in the end of oils supplementation. Further investigated the effects of oils supplement on rats with cecal ligation and puncture (CLP)-induced sepsis. The saline supplement rats receiving CLP operation produced significant signs of DIC responses at 14~18hrs after CLP, including increased PT (22.6 ± 1.6 vs. 42.4 ± 3.5 sec, p＜0.05), APTT (37.4 ± 6.5 vs. 107.9 ± 10.2 sec, p＜0.05), as well as decreased plasma fibrinogen content (432.9 ± 44.9 vs. 231.2 ± 52.0 mg/dl, p＜0.05). The rats receving fish oil or safflower seed oil supplement for 30 days were without significant signs of DIC responses in septic rats. In contrast, coconut oil supplement did not reversed the coagulopathy responses in rats with CLP-induced sepsis. Moreover, the saline supplement rats receving CLP operation produced significant signs of hepatic and renal dysfunction, including increased ALT (20.3 ± 2.2 vs. 74.1 ± 6.1 mg/dl, p＜0.05), TBIL (0.33 ± 0.02 vs. 1.13 ± 0.12 mg/dl, p＜0.05), BUN (12.8 ± 0.5 vs. 50.6 ± 9.3 mg/dl, p＜0.05), and CRE (0.59 ± 0.04 vs. 1.04 ± 0.18 mg/dl, p＜0.05). Fish oil or safflower seed oil supplment reduced serum levels of ALT, TBIL, BUN and CRE in septic rats. In contrast, coconut oil supplement did not liver and kidney of septic rats. These results suggesting that fish oil or safflower seed oil supplement improve hepatic and renal functions of septic rats. In contrast, saline or coconut oil supplement did not offer protective effects on hepatic and renal functions in septic rats. In conclusion, fish oil or safflower seed oil supplement ameliorated DIC responses and organ injury in rats with sepsis.
| Identifer | oai:union.ndltd.org:TW/093PCCU0115017 |
| Date | January 2005 |
| Creators | Hsiang-Chen Yang, 楊湘晨 |
| Contributors | Chien-Cheng Hsieh, 謝建正 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 0 |
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