ω-3鱼油脂肪乳对脓毒症患者氧化应激指标的影响

Effects of omega-3 fish oil fat emulsion on oxidative stress in the patients with sepsis

目的 探讨ω-3鱼油脂肪乳对脓毒症患者氧化应激指标的影响.方法 40例脓毒症患者随机分为常规TPN组（A组）和ω-3鱼油脂肪乳＋TPN组（B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2 mL/（kg·d）,共5 d.两组患者于治疗前和治疗后第1、3、6天清晨抽取静脉血进行氧化应激指标检测.结果 A组完成18例,有2例退出; B组完成19例,有1例退出.两组患者在年龄及入ICU 24 h内APACHEⅡ评分方面比较差异无统计学意义（P〉0.05）.B组MDA水平有下降趋势,在治疗后第6天与A组比较差异有统计学意义（P〈0.05）.B组SOD活性、T-AOC水平有上升趋势,在治疗后第3、6天与A组比较差异均有统计学意义（P〈0.05）.B组NO水平有下降趋势,在治疗后第3、6天与A组比较差异均有统计学意义（P〈0.05）.B组GSH-PX活性有上升趋势,在治疗后第6天与A组比较差异有统计学意义（P〈0.01）.结论 ω-3鱼油脂肪乳可以改善脓毒症患者的氧化应激指标.

Objective To investigate the effects of omega - 3 fish oil fat emulsion on oxidative stress in the patients with sepsis. Methods 40 patients with 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）. All patients received equivalent nitrogen and calorie values in TPN. Group B was given extra ω -3 fish oil fat emulsion 2 mL/（ kg· d） for 5 days. Indices of oxidative stress were detected before treatment, on the 1st, the 3rd and the 6th clay after treatment. Results 18 patients completed and two eases exited in group A. 19 patients completed and 1 case exited in group B. There was no difference in ages and APACHE 11 score within 24 hours entering ICU between group A and group B （P 〉0. 05）. The levels of serum malonyldialdehyde （MDA）had a downward tendency in group B. There were significant differences between the two groups at 6th day after treatment（P 〈 0. 05）. The levels of superoxide disnmtase （ SOD ） and total antioxidative capability （ T - AOC ） had an increasing tendency in group B, and there were significant differences between two groups at the 3rd and the 6th day after treatment （P 〈 0. 05）. The levels of serum nitric oxide （NO）had shown a decline in group B, and there were significantly differences between the two groups at the 3rd and the 6th day after treatment （P 〈 0. 05 ）. The activities of glutathione peroxidase （ GSH - PX） had an upward tendency in group B, there were significant differences between two groups at 6th day after treatment （ P 〈 0. 01 ）. Conclusion Omega - 3 fish oil fat emulsion can improve the indices of oxidative stress in the patients with sepsis.