ω-3脂肪酸对脓毒症患者临床预后影响的回顾性真实世界研究

A Retrospective Real Word Study of the Effect of Omega-3 Fatty Acids on the Clinical Prognosis of Patients with Sepsis

目的回顾性分析ω-3脂肪酸对脓毒症患者临床预后的影响。方法回顾性分析2016年12月-2019年6月期间我院收治的1733例脓毒症患者的临床和随访资料,依据患者是否接受ω-3鱼油脂肪乳治疗分组,303例接受为ω-3鱼油脂肪乳组,余1430例未接受为对照组。比较两组患者的常见实验室检查指标、预后及不良反应情况。结果两组的性别、年龄、感染种类、APACHE评分、糖尿病、高血压及脑出血发生率、能量供给量、蛋白质、脂肪、肠外营养时间、肠外营养输注途径比较差异统计学无意义(P>0.05)。ω-3鱼油脂肪乳组用药第9d时血清WBC、PCT、AST、TC、TG水平均低于对照组,有统计学意义(P<0.05)。ω-3鱼油脂肪乳组的氧合指数、机械通气时间、VAP发生率、28d病死率均低于对照组,脱机成功率高于对照组,有统计学意义(P<0.05)。ω-3鱼油脂肪乳组患者的死亡累积风险及病死率较对照组降低。结论ω-3鱼油脂肪乳组患者的死亡积累风险及病死率更低,ω-3鱼油脂肪乳可能改善脓毒症患者的预后,未发现明显不良反应。

Objective To retrospectively analyze the effect of omega-3 fatty acids on the clinical prognosis of patients with sepsis.Methods The clinical data and follow-up data of 1733 patients with sepsis admitted to our hospital from December 2016 to June 2019 were retrospectively analyzed.Based on whether the patients received omega-3 fish oil and fat emulsion treatment,303 patients received omega 3 Fish oil fat milk group,the remaining 1430 cases were not accepted as the control group.The baseline conditions,common laboratory test indicators,prognosis and adverse reactions of the two groups of patients were compared.Results Gender,age,type of infection,focus of infection,APACHE score,incidence of diabetes,hypertension and cerebral hemorrhage,energy supply,protein,fat,parenteral nutrition time,parenteral nutrition between the omega-3 fish oil fat emulsion group and the control group There was no significant difference in the infusion route(P>0.05).The serum BUN level of the omega-3 fish oil fat emulsion group was lower than that of the control group on the 1st day of treatment;the serum hsCRP,PCT,TC and TG levels were lower than the control group on the 5th day of treatment;the serum level of the 9th day of treatment The levels of WBC,PCT,AST,TC and TG were lower than those of the control group,which was meaningful(P<0.05).The oxygenation index,mechanical ventilation time,VAP incidence,and 28-day mortality rate in the omega-3 fish oil fat milk group were all lower than those in the control group,the offline success rate was higher than the control group,which was significant(P<0.05).The risk of death accumulation in patients in the omega-3 fish oil fat milk group gradually decreased,and the mortality rate gradually decreased.Patients in the omega-3 fish oil fat milk group did not show any obvious adverse reactions during the use of the drug.Conclusion Omega-3 fish oil fat emulsion can improve the prognosis of patients with sepsis.With the prolongation of ICU hospitalization,the cumulative risk of death of patients gradually decreases,the mortality rate gradually decreases,and there are no obvious adverse reactions,and the safety is better.