摘要
目的 观察ω-3多不饱和脂肪酸在严重脓毒症机械通气早期的保护作用.方法 将32例严重脓毒症机械通气的患者随机分为对照组（17例）和治疗组（15例）.使用等氮、等热量肠内及肠外混合营养共5 d,热量为113 kJ（27 kcal）/（kg·d）.对照组病人用中长链脂肪乳剂,研究组病人用ω-3鱼油脂肪乳＋中长链脂肪乳剂.分别在试验开始前和试验第6天早晨,抽血检测白细胞数、总蛋白、白蛋白、MDA、血浆C反应蛋白、血气分析指标（动脉氧分压、动脉二氧化碳分压氧合指数）,同时记录患者临床体征（心率、呼吸、体温）及进行APACHEⅡ评分.结果 添加鱼油脂肪乳的患者呼吸情况（17.13±3.78）次/分、氧合情况（251.27±52.68）、CRP（46.13±25.33）及APACHEⅡ评分（ 14±3.67）分及MDA（7.95±2.48）分,较对照组明显改善（P〈0.05）.结论 ω-3多不饱和脂肪酸在严重脓毒症机械通气患者早期应用可以降低患者体内过渡的炎症反应,减少氧化应激产物的生成,改善患者的氧合情况.
Objective To evaluate whether ω -3 polyunsaturated fatty acids supplementation affects inflammatory response and oxidative stress in severe sepsis patients requiring mechanical ventilation. Metbods The design was a prospective, randomized, double-blind, parallel group study in our Emergency Intensive Medicine Department. We studied 32 patients with severe sepsis requiring mechanical ventilation, who received partial parenteral nutrition and partial parenteral nutrition for 5 days.Patients were randomized into 2 groups in order to receive ω-3 lipid-infusion （fish oil-based; Omegaven）or not. One is the control group（n=17）, the other is the omega-3 group（n=15）. The two groups were comparable in terms of sex distribution, age, serum albumin and APACHE Ⅱ score. Blood samples taken from patients before and at the end of the study period were examined including serum concentrations of white blood cell, total protein, albumin, blood gas analysis, C reactive protein and malondia1dehyde （MDA） on the first and sixth day. The vital signs and APACHE Ⅱ score were recorded.Results There were significant differences in breathing, APACHE Ⅱ score, arterial oxygen pressure, oxygenation index, C reactive protein and malondia ldehyde （MDA） between two groups（P〈0.05）. No adverse effect attributable to the lipid emulsions was seen in the patients analyzed. Conclusions Supplemented with ω-3 polyunsaturated fatty acids appeared to diminishes inflammatory response, oxidative stress, improve gas exchange in severe sepsis patients requiring mechanical ventilation. The lipid emulsion enriched with ω -3 polyunsaturated fatty acids was safe and well tolerated in short-term administration to severe sepsis patients requiring mechanical ventilation.
出处
《国际医药卫生导报》
2011年第2期142-146,共5页
International Medicine and Health Guidance News
基金
深圳市科技计划非资助项目（201003044）
关键词
脓毒症
Ω-3不饱和脂肪酸
机械通气
Severe sepsis
Omega-3 polyunsaturated fatty acids （PUFA）
Mechanical ventilation
