含ω-3多不饱和脂肪酸的不同脂肪乳剂营养支持治疗重症患者的疗效比较

Comparative efficacy of different fat emulsions containingω-3 polyunsaturated fatty acids in the nutritional support of critically ill patients

目的比较含ω-3多不饱和脂肪酸(ω-3 PUFA)的不同脂肪乳剂治疗重症患者的疗效。方法回顾性分析安徽医科大学附属六安医院2018年5月至2023年5月接受含ω-3 PUFA的脂肪乳剂治疗重症患者临床资料,根据全肠外营养处方中不同脂肪乳构成,分为多种油脂肪乳组和ω-3鱼油脂肪乳联合长链或中/长链脂肪乳组,比较两组总住院时间、ICU入住时间、脂肪乳总费用、住院总费用、全肠外营养治疗总费用、药品费用占比、保肝药物使用率、患者好转率、总胆红素、白蛋白、AST、ALT、WBC计数、中性粒细胞百分比及C反应蛋白水平。结果共纳入多种油脂肪乳组106例,ω-3鱼油指肪乳联合长链或中/长链脂肪乳组76例。治疗后,两组患者的总住院时间、ICU入住时间、住院总费用、保肝药物使用率及患者好转率比较,差异均无统计学意义(P>0.05);与ω-3鱼油脂肪乳联合长链或中/长链脂肪乳组比较,多种油脂肪乳组可降低脂肪乳总费用、全肠外营养治疗总费用及药品费用占比,差异均有统计学意义(P<0.05);两组患者肝功能和炎症指标水平比较,差异均无统计学意义(P>0.05)。结论在重症患者全肠外营养处方设计时,在控制药品费用占比的情况下,可用多种油脂肪乳替代ω-3鱼油脂肪乳联合长链或中/长链脂肪乳,2种处方临床疗效并无差异。

Objective To compare the efficacy of fat emulsions containingω-3 polyunsaturated fatty acids(ω-3 PUFA)in the nutritional support of critically ill patients.Methods A retrospective analysis was conducted on the clinical data of criti⁃cally ill patients treated with containingω-3 PUFA-based fat emulsions in Lu'an Hospital Affiliated to Anhui Medical Universi⁃ty from May 2018 to May 2023.According to the total parenteral nutrition(TPN)prescription of different fat emulsions compo⁃sition,patients were divided into multi-oil lipid emulsion group andω-3 fish oil lipid emulsion combined with long or medi⁃um/long chain lipid emulsion group.The total hospitalization stay,ICU stay duration,total cost of lipid emulsion,total hospi⁃talization cost,total cost of TPN treatment,proportion of medical costs,hepatoprotective drug usage rate,patient improve⁃ment rate,total bilirubin,albumin,AST,ALT,WBC count,neutrophils percentage,and C-reactive protein(CRP)levels were compared between the two groups.Results A total of 106 cases were included in the multi-oil lipid emulsion group and 76 cases in theω-3 fish oil lipid emulsion combined with long or medium/long chain lipid emulsion group.After treatment,there were no significant differences in total hospitalization stay,ICU stay duration,total hospitalization cost,hepatoprotective drug usage rate of and patient improvement rate between the two groups(P>0.05).Compared with theω-3 fish oil lipid emul⁃sion combined with long or medium/long chain lipid emulsion group,the multi-oil liupid emulsion group showed significant reductions in total lipid emulsion cost,total TPN treatment cost,and the proportion of medication costs(P<0.05).No signifi⁃cant differences were observed between the two groups in the improvement of liver function and inflammatory index levels(P>0.05).Conclusion In the design of TPN prescriptions for critically ill patients,using the multi-oil lipid emulsion can replaceω-3 fish oil lipid emulsion combined with long or medium/long chain lipid emulsion to control the proportion of medication costs,with no difference in clinical efficacy between the two prescriptions.