ω-3脂肪乳剂减轻重症患者全身性炎性反应综合征的临床疗效观察

Clinical observation of ω-3 fatty emulsion in reducing systemic inflammatory response in critically ill patients

目的观察和探讨ω-3脂肪乳剂减轻重症患者全身炎性反应综合征(SIRS)的临床疗效。方法选择安徽省马鞍山市人民医院重症医学科2011年5月～2013年4月收治的SIRS患者96例,随机将所有患者分为实验组和对照组,每组各48例。对照组患者使用普通20%中长链脂肪乳剂500 mL/d治疗;实验组在对照组的基础上再加用ω-3脂肪乳剂100 mL/d静滴治疗,治疗持续1周。治疗前后检测患者的C-反应蛋白(CRP)、降钙素原(PCT)、IL(白介素)-1、IL-6、IL-8、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平,并行急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分。结果治疗前两组患者CRP、PCT、IL-1、IL-6、IL-8、ALT和AST水平以及APACHEⅡ评分差异无统计学意义(P>0.05);治疗后,实验组CRP、PCT、IL-1、IL-6、IL-8、ALT和AST水平以及APACHEⅡ评分显著降低,且与对照组相比降低更为明显,差异具有统计学意义(P<0.05)。结论ω-3脂肪乳剂减轻重症患者SIRS的临床效果显著,预后提升明显,值得在临床上进一步推广。

Objective To observe and discuss the effect of ω-3 fatty emulsion in reducing systemic inflammatory response in critically ill patients. Methods 96 patients with SIRS in Department of Critical Care Medicine,People＇s Hospital of Ma＇anshan City from May 2011 to April 2013 were selected. All patients were randomly divided into experimental group and control group,48 cases in each group. Control group were treated with 20% normal long chain fat emulsion for 500 mL/d; and experimental group treated with ω-3 fatty emulsion 100 mL/d intravenous therapy based on the combined use of normal long chain fat emulsion. Treatment continued for 1 week,the level of CRP,procalcitonin（PCT）,IL-1,IL-6,IL-8,alanine transaminase（ALT）,aspartate aminotransferase（AST） were detected and scored them with parallel acute physiology and chronic health condition scoring system Ⅱ（APACHE Ⅱ） before and after treatment. Results Before treatment,the levels of CRP,PCT,IL-1,IL-6,IL-8,ALT and AST as well as APACHE Ⅱ scores were not statistically significant between the two groups（P 〉0.05）. But after treatment,the levels of CRP,PCT,IL-1,IL-6,IL-8,ALT and AST as well as APACHE Ⅱ scores in the experimental group significantly reduced,compared with the control group,the differences were statistically significant（P 〈0.05）. Conclusion The effect of ω-3 fatty emulsion in reducing the clinical effects in patients with severe SIRS is obvious,it also can significantly improve the prognosis,thus worth for further promotion in clinic.