ω-3鱼油脂肪酸治疗脓毒症相关性急性肾损伤的临床分析

Effect of omega 3 fish oil on treating sepsis- associated acute kidney injury

目的探讨ω-3鱼油脂肪酸对脓毒症并急性肾损伤(AKI)患者的疗效。方法纳入脓毒症并AKI患者并随机分成对照组及观察组。所有患者参照脓毒症治疗指南实施治疗,观察组在对照组基础上,同时给予ω-3鱼油脂肪酸治疗。结果共纳入32例患者,基线无差异。观察组病死率较对照组下降(37.5%vs 50%),但差别无统计学意义(P=0.476)。APACHE II评分、Marshall评分比对照组下降(P值分别为0.041,0.021)。观察组进展至需要血液净化治疗(CRRT)的6例,对照组进展至需CRRT的8例,两组中需行CRRT的患者,观察组CRRT天数低于对照组(P值为0.047),观察组肌酐、尿素氮较对照组有下降,但无统计学意义(P值为0.081,0.094)。结论ω-3鱼油脂肪酸对于降低脓毒症相关性AIK病死率及改善受损器官功能情况有一定帮助,但结果需要更大规模临床随机对照试验(RCT)验证。

Objective To observe the effects of Omega3 fish oil on acute kidney injury （AKI） associated with sepsis. Methods Patients with sepsis - associated AKI were included, and randomly arranged to treatment and control groups. All patients were treated according to guidelines. But omega 3 fish oil was added in treatment group, in addition to therapies in control group. Results A total of thirty - two patients were included. Differences of baseline were insignificant. Mortality rate in treatment group was lower than that in control group （37.5% vs 50% ）, but the difference is non -significant （P =0. 476）. APACHE II and Marshall Scores were also lower in treatment group, comparing to those of control group （p values were 0. 041, and 0. 021 respectively）. Six cases in treatment group and eight in control group had to receive continuous renal replacement treatment （CRRT）. The CRRT incidence rate is lower in treatment group than that in control group （P = 0. 047）. Creatinine and blood urea nitrogen （BUN） reduced in treatment group, but the difference between both groups was insignificant （p values were 0.081, and 0. 094, respectively）. Conclusions Omega 3 fish oil can possibly reduce mortality of patients with sepsis - associated AKI. It is also helpful to improve organs function, but its effects should be examined with larger scale RCTs.