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Article(id=1208106712729493973, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1208106710208717234, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.2022.04.0390, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1624204800000, receivedDateStr=2021-06-21, revisedDate=null, revisedDateStr=null, acceptedDate=1628524800000, acceptedDateStr=2021-08-10, onlineDate=1765964685852, onlineDateStr=2025-12-17, pubDate=1651075200000, pubDateStr=2022-04-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1765964685852, onlineIssueDateStr=2025-12-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1765964685852, creator=13701087609, updateTime=1765964685852, updator=13701087609, issue=Issue{id=1208106710208717234, tenantId=1146029695717560320, journalId=1189873630562394117, year='2022', volume='47', issue='4', pageStart='321', pageEnd='426', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1765964685250, creator=13701087609, updateTime=1765964685250, updator=13701087609, preIssue=null, nextIssue=null, ext=null, issueFiles=null}, startPage=390, endPage=393, ext={EN=ArticleExt(id=1208106713006318042, articleId=1208106712729493973, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Effect of intravenous supplementation of omega-3 fish oil on the prognosis of patients with sepsis, columnId=1190310109000602400, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Clinical Research, runingTitle=null, highlight=null, articleAbstract=

Objective To investigate the effect of intravenous omega-3 fish oil on the prognosis of patients with sepsis. Methods 1733 patients with sepsis were selected from the Department of Critical Care Medicine of Shenzhen People's Hospital from December 1, 2016 to June 30, 2019. According to the survival situation, these patients were divided into survival group(n=1351) and death group (n=382). The general information, infection site, complications, organ support measures and clinical outcomes were analyzed and compared between the two groups. Multivariate logistic regression and Kaplan-Meier survival analysis were performed to evaluate the effect of intravenous supplementation of omega-3 fish oil on the prognosis of patients with sepsis. Results There were significant differences in gender, age, pulmonary infection, abdominal infection, blood infection,complication, mechanical ventilation, renal replacement therapy and omega-3 fish oil intervention between survival group and death group (P<0.05). There was no significant difference in the proportion of biliary tract infection, urinary tract infection and other site infections between the two groups (P>0.05). Logistic regression analysis showed that men, old age, bloodstream infection,mechanical ventilation support, and renal replacement therapy were risk factors for the survival status of patients with sepsis within 90 days, and intravenous omega-3 fish oil supplementation was a protective factor for sepsis. Survival analysis results show that intravenous supplementation of omega-3 fish oil can improve the 90-day survival rate of patients with sepsis. Conclusion Omega-3 fish oil intervention can improve the prognosis of patients with sepsis, and the clinical application feasibility is high.

, correspAuthors=Huai-Sheng Chen, authorNote=null, correspAuthorsNote=
*E-mail:
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目的 探讨静脉补充Omega-3鱼油对脓毒症患者预后的影响。方法 选取2016年12月1日－2019年6月30日深圳市人民医院重症医学科收治的1733例脓毒症患者，根据其生存情况分为两组，其中生存组1351例，死亡组382例。比较两组患者的一般资料、感染部位、并发症、器官支持措施、临床结局等指标，采用多元logistic回归及Kaplan-Meier生存曲线分析静脉补充Omega-3鱼油对脓毒症患者预后的影响。结果 生存组与死亡组性别，年龄，肺部感染、腹腔感染、血行性感染患者比例，并发症，机械通气、肾脏替代治疗及Omega-3鱼油干预比例差异有统计学意义(P<0.05)，两组胆道感染、泌尿系感染及其他部位感染患者比例差异无统计学意义(P>0.05)。多元logistic回归分析结果显示，男性、年龄大、血行性感染、机械通气支持、肾脏替代治疗是脓毒症患者90 d预后的危险因素，静脉补充Omega-3鱼油是脓毒症患者90 d预后的保护因素。生存曲线分析结果显示，静脉补充Omega-3鱼油能提高脓毒症患者90 d生存率。结论 Omega-3鱼油干预能改善脓毒症患者的预后，临床应用可行性高。

, correspAuthors=陈怀生, authorNote=null, correspAuthorsNote=
陈怀生，E-mail：
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陈友莲，医学硕士，主治医师，主要从事脓毒症、急性呼吸窘迫综合征等方面的研究

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陈友莲，医学硕士，主治医师，主要从事脓毒症、急性呼吸窘迫综合征等方面的研究

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陈友莲，医学硕士，主治医师，主要从事脓毒症、急性呼吸窘迫综合征等方面的研究

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Nutrients, 2015, 7(7): 5572-5585., articleTitle=Enteral immunomodulatory diet (omega-3 fatty acid, γ-linolenic acid and antioxidant supplementation) for acute lung injury and acute respiratory distress syndrome: an updated systematic review and meta-analysis, refAbstract=null), Reference(id=1208106717234176654, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, doi=null, pmid=null, pmcid=null, year=2015, volume=26, issue=9, pageStart=1265, pageEnd=1267, url=null, language=null, rfNumber=[16], rfOrder=16, authorNames=Zhang HD, Chen HS, Hong CY, journalName=Hainan Med J, refType=null, unstructuredReference=Zhang HD, Chen HS, Hong CY, et al. Efficacy of omega 3 fish oil in the treatment of sepsis patients with intestinal dysfunction and its effect on immunological function[J]. Hainan Med J, 2015, 26(9): 1265-1267., articleTitle=Efficacy of omega 3 fish oil in the treatment of sepsis patients with intestinal dysfunction and its effect on immunological function, refAbstract=null), Reference(id=1208106717322257045, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, doi=null, pmid=null, pmcid=null, year=2015, volume=26, issue=9, pageStart=1265, pageEnd=1267, url=null, language=null, rfNumber=[16], rfOrder=17, authorNames=张华东, 陈怀生, 洪澄英, journalName=海南医学, refType=null, unstructuredReference=[张华东, 陈怀生, 洪澄英, 等. ω3鱼油脂肪酸治疗脓毒症并肠功能障碍的疗效及其对患者免疫功能的影响[J]. 海南医学, 2015, 26(9): 1265-1267.], articleTitle=ω3鱼油脂肪酸治疗脓毒症并肠功能障碍的疗效及其对患者免疫功能的影响, refAbstract=null), Reference(id=1208106717410337437, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, doi=null, pmid=null, pmcid=null, year=2014, volume=35, issue=23, pageStart=3449, pageEnd=3451, url=null, language=null, rfNumber=[17], rfOrder=18, authorNames=Hong CY, Zhang WX, Chen HS, journalName=J Qiqihar Med Coll, refType=null, unstructuredReference=Hong CY, Zhang WX, Chen HS. Effect of omega 3 fish oil on treating sepsis - associated acute kidney injury[J]. J Qiqihar Med Coll, 2014, 35(23): 3449-3451., articleTitle=Effect of omega 3 fish oil on treating sepsis - associated acute kidney injury, refAbstract=null), Reference(id=1208106717523583651, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, doi=null, pmid=null, pmcid=null, year=2014, volume=35, issue=23, pageStart=3449, pageEnd=3451, url=null, language=null, rfNumber=[17], rfOrder=19, authorNames=洪澄英, 张卫星, 陈怀生, journalName=齐齐哈尔医学院学报, refType=null, unstructuredReference=[洪澄英, 张卫星, 陈怀生. 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[J]. 齐齐哈尔医学院学报, 2014, 35(23): 3449-3451.], articleTitle=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, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1208106713702572518, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, xref=null, ext=[AuthorCompanyExt(id=1208106713710961127, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, companyId=1208106713702572518, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Critical Care Medicine, Shenzhen People’s Hospital, Shenzhen, Guangdong 518020, China), AuthorCompanyExt(id=1208106713715155432, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, companyId=1208106713702572518, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=深圳市人民医院重症医学科，广东深圳 518020)])], figs=[ArticleFig(id=1208106715095081487, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, language=EN, label=Fig.1, caption=Effect of omega-3 fish oil intervention on survival rate of patients with sepsis, figureFileSmall=CtI3f7JQoTTKs/h4Ei2pAA==, figureFileBig=rQ1fU6rEasr3IL/16xZlRA==, tableContent=null), ArticleFig(id=1208106715166384659, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, language=CN, label=图1, caption=Omega-3鱼油干预对脓毒症患者生存率的影响, figureFileSmall=CtI3f7JQoTTKs/h4Ei2pAA==, figureFileBig=rQ1fU6rEasr3IL/16xZlRA==, tableContent=null), ArticleFig(id=1208106715350934045, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, language=EN, label=Tab.1, caption=

Comparison of the baseline data of patients with sepsis between the two groups

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项目生存组(n=1351)死亡组(n=382)χ2/tP
性别[例(%)]  11.3950.001
 男761(56.3)252(66.0)
 女590(43.7)130(34.0)
年龄(岁，$\bar{x}±s$)62.2±19.165.4±20.22.8540.004
感染部位[例(%)]
 肺部感染265(19.6)63(16.5)27.8530.004
 腹腔感染143(10.6)33(8.6)33.312<0.001
 胆道感染123(9.1)23(6.0)0.4820.442
 泌尿系感染106(7.9)12(3.1)0.1381.000
 血行性感染218(16.1)102(26.7)35.887<0.001
 其他496(36.7)149(39.0)0.0250.899
并发症[例(%)]
 休克1129(83.6)339(88.7)14.052<0.001
 血小板减少373(27.6)239(62.6)4.614<0.001
 乳酸增高345(25.5)138(36.1)–6.089<0.001
机械通气[例(%)]  20.055<0.001
 是761(56.3)307(80.4)
 否590(43.7)75(19.6)
肾脏替代治疗[例(%)]  31.934<0.001
 是186(13.8)158(41.4)
 否1165(86.2)224(58.6)
Omega-3鱼油干预[例(%)]  19.861<0.001
 是207(15.3)96(25.2)
 否1144(84.7)286(74.8)  
), ArticleFig(id=1208106715451597344, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, language=CN, label=表1, caption=

两组脓毒症患者基线资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
项目生存组(n=1351)死亡组(n=382)χ2/tP
性别[例(%)]  11.3950.001
 男761(56.3)252(66.0)
 女590(43.7)130(34.0)
年龄(岁，$\bar{x}±s$)62.2±19.165.4±20.22.8540.004
感染部位[例(%)]
 肺部感染265(19.6)63(16.5)27.8530.004
 腹腔感染143(10.6)33(8.6)33.312<0.001
 胆道感染123(9.1)23(6.0)0.4820.442
 泌尿系感染106(7.9)12(3.1)0.1381.000
 血行性感染218(16.1)102(26.7)35.887<0.001
 其他496(36.7)149(39.0)0.0250.899
并发症[例(%)]
 休克1129(83.6)339(88.7)14.052<0.001
 血小板减少373(27.6)239(62.6)4.614<0.001
 乳酸增高345(25.5)138(36.1)–6.089<0.001
机械通气[例(%)]  20.055<0.001
 是761(56.3)307(80.4)
 否590(43.7)75(19.6)
肾脏替代治疗[例(%)]  31.934<0.001
 是186(13.8)158(41.4)
 否1165(86.2)224(58.6)
Omega-3鱼油干预[例(%)]  19.861<0.001
 是207(15.3)96(25.2)
 否1144(84.7)286(74.8)  
), ArticleFig(id=1208106715539677733, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, language=EN, label=Tab.2, caption=

Multivariate logistic regression analysis of the factors affecting the prognosis of patients with sepsis

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因素βSEWald χ2POR95%CI
性别–0.2620.1333.9040.0480.7690.593~0.998
年龄0.0230.00441.2280.00011.0231.016~1.030
腹腔感染0.3150.2941.1420.2851.3700.769~2.440
血行性感染–0.9540.16832.4100.0000.3850.277~0.535
脓毒性休克–0.0720.1920.1420.7060.9300.638~1.355
机械通气支持–0.9850.14844.2560.00010.3730.279~0.499
肾脏替代治疗–1.3370.14387.6950.0000.2630.199~0.347
静脉补充Omega-3鱼油0.0910.1600.3170.5741.0940.800~1.497
), ArticleFig(id=1208106715665506861, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208106712729493973, language=CN, label=表2, caption=

影响脓毒症患者预后的多元logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素βSEWald χ2POR95%CI
性别–0.2620.1333.9040.0480.7690.593~0.998
年龄0.0230.00441.2280.00011.0231.016~1.030
腹腔感染0.3150.2941.1420.2851.3700.769~2.440
血行性感染–0.9540.16832.4100.0000.3850.277~0.535
脓毒性休克–0.0720.1920.1420.7060.9300.638~1.355
机械通气支持–0.9850.14844.2560.00010.3730.279~0.499
肾脏替代治疗–1.3370.14387.6950.0000.2630.199~0.347
静脉补充Omega-3鱼油0.0910.1600.3170.5741.0940.800~1.497
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静脉补充Omega-3鱼油对脓毒症患者预后的影响
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陈友莲 , 陈怀生 *
解放军医学杂志 | 临床研究 2022,47(4): 390-393
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解放军医学杂志 | 临床研究 2022, 47(4): 390-393
静脉补充Omega-3鱼油对脓毒症患者预后的影响
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陈友莲, 陈怀生*
作者信息
  • 深圳市人民医院重症医学科，广东深圳 518020

    • 陈友莲，医学硕士，主治医师，主要从事脓毒症、急性呼吸窘迫综合征等方面的研究

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陈怀生，E-mail：
Effect of intravenous supplementation of omega-3 fish oil on the prognosis of patients with sepsis
You-Lian Chen, Huai-Sheng Chen*
Affiliations
  • Department of Critical Care Medicine, Shenzhen People’s Hospital, Shenzhen, Guangdong 518020, China
出版时间: 2022-04-28 doi: 10.11855/j.issn.0577-7402.2022.04.0390
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摘要
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目的 探讨静脉补充Omega-3鱼油对脓毒症患者预后的影响。方法 选取2016年12月1日－2019年6月30日深圳市人民医院重症医学科收治的1733例脓毒症患者，根据其生存情况分为两组，其中生存组1351例，死亡组382例。比较两组患者的一般资料、感染部位、并发症、器官支持措施、临床结局等指标，采用多元logistic回归及Kaplan-Meier生存曲线分析静脉补充Omega-3鱼油对脓毒症患者预后的影响。结果 生存组与死亡组性别，年龄，肺部感染、腹腔感染、血行性感染患者比例，并发症，机械通气、肾脏替代治疗及Omega-3鱼油干预比例差异有统计学意义(P<0.05)，两组胆道感染、泌尿系感染及其他部位感染患者比例差异无统计学意义(P>0.05)。多元logistic回归分析结果显示，男性、年龄大、血行性感染、机械通气支持、肾脏替代治疗是脓毒症患者90 d预后的危险因素，静脉补充Omega-3鱼油是脓毒症患者90 d预后的保护因素。生存曲线分析结果显示，静脉补充Omega-3鱼油能提高脓毒症患者90 d生存率。结论 Omega-3鱼油干预能改善脓毒症患者的预后，临床应用可行性高。

脓毒症  /  Omega-3鱼油  /  生存率

Objective To investigate the effect of intravenous omega-3 fish oil on the prognosis of patients with sepsis. Methods 1733 patients with sepsis were selected from the Department of Critical Care Medicine of Shenzhen People's Hospital from December 1, 2016 to June 30, 2019. According to the survival situation, these patients were divided into survival group(n=1351) and death group (n=382). The general information, infection site, complications, organ support measures and clinical outcomes were analyzed and compared between the two groups. Multivariate logistic regression and Kaplan-Meier survival analysis were performed to evaluate the effect of intravenous supplementation of omega-3 fish oil on the prognosis of patients with sepsis. Results There were significant differences in gender, age, pulmonary infection, abdominal infection, blood infection,complication, mechanical ventilation, renal replacement therapy and omega-3 fish oil intervention between survival group and death group (P<0.05). There was no significant difference in the proportion of biliary tract infection, urinary tract infection and other site infections between the two groups (P>0.05). Logistic regression analysis showed that men, old age, bloodstream infection,mechanical ventilation support, and renal replacement therapy were risk factors for the survival status of patients with sepsis within 90 days, and intravenous omega-3 fish oil supplementation was a protective factor for sepsis. Survival analysis results show that intravenous supplementation of omega-3 fish oil can improve the 90-day survival rate of patients with sepsis. Conclusion Omega-3 fish oil intervention can improve the prognosis of patients with sepsis, and the clinical application feasibility is high.

sepsis  /  omega-3 fish oil  /  survival rate
陈友莲, 陈怀生. 静脉补充Omega-3鱼油对脓毒症患者预后的影响. 解放军医学杂志, 2022 , 47 (4) : 390 -393 . DOI: 10.11855/j.issn.0577-7402.2022.04.0390
You-Lian Chen, Huai-Sheng Chen. Effect of intravenous supplementation of omega-3 fish oil on the prognosis of patients with sepsis[J]. Medical Journal of Chinese People’s Liberation Army, 2022 , 47 (4) : 390 -393 . DOI: 10.11855/j.issn.0577-7402.2022.04.0390
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近年来，随着对脓毒症发病原因及机制研究的不断深入，脓毒症的概念已更新至Sepsis 3.0[1]，各种治疗技术也不断进步，如1 h集束化治疗、抗生素管理、免疫调理、器官支持等[2]，但脓毒症患者的病死率仍高达30%~70%[3]。脓毒症被认为是因感染引起的宿主反应失调导致的危及生命的器官功能障碍，其中失衡的全身炎症及免疫反应是脓毒症发生发展的关键机制[4]。Omega-3鱼油除了可以为机体提供能量及营养物质外，还具有抗血栓、调节免疫、抗炎等作用，将其应用于脓毒症，能起到抑制炎症、调节免疫、改善细胞免疫功能等作用，进而有助于控制感染，改善预后[5]。但也有研究发现，鱼油可能对脓毒症患者产生不利影响[6]。目前脓毒症患者静脉补充Omega-3鱼油对预后的影响尚不明确。本研究通过分析脓毒症患者90 d生存率的影响因素，探讨Omega-3鱼油干预对脓毒症患者预后的影响。
1 资料与方法
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1.1 一般资料
选取深圳市人民医院重症医学科2016年12月1日－2019年6月30日收治的1733例脓毒症患者。均符合2016年美国重症医学会(SCCM)与欧洲重症医学会(ESICM)联合发布的脓毒症诊断标准(Sepsis 3.0)[1]。排除标准：(1)年龄小于18岁；(2)因慢性疾病或恶性肿瘤预期寿命<28 d；(3)放弃积极治疗；(4)合并血液病、风湿病或严重肝功能障碍。本研究经医院伦理委员会审批，纳入患者均签署知情同意书。
1.2 研究方法
收集所有纳入患者的基线资料，包括性别、年龄、感染部位、基础疾病等。按脓毒症诊治指南对纳入患者进行微生物培养、抗感染治疗、液体复苏、机械通气、血液净化治疗等，其中303例接受了静脉补充Omega-3鱼油治疗，1430例未予补充。Omega-3鱼油使用方法：静脉滴注，剂量为0.2 g/(kg·d)，输注速度为0.05 g/(kg·h)。根据患者生存情况将患者分为生存组(1351例)与死亡组(382例)。比较两组的相关临床资料，分析Omega-3鱼油干预对脓毒症患者预后的影响。
1.3 统计学处理
采用SPSS 20.0软件对数据进行统计分析。正态分布计量资料以$\bar{x}±s$表示，两组比较采用独立样本t检验；计数资料以例(%)表示，组间比较采用χ2检验。采用多元logistic回归分析脓毒症患者预后的影响因素，采用Kaplan-Meier法绘制生存曲线，生存率差异比较采用Log-rank χ2检验。P<0.05为差异有统计学意义。
2 结果
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2.1 两组脓毒症患者一般资料比较
两组脓毒症患者胆道感染、泌尿系感染及其他部位感染比例差异无统计学意义(P>0.05)，两组性别，年龄，肺部感染、腹腔感染、血行性感染患者比例，并发症，机械通气、肾脏替代治疗及Omega-3鱼油干预比例差异有统计学意义(P<0.05，表1)。
2.2 影响脓毒症患者预后的多元logistic回归分析
以脓毒症患者90 d内的生存状态为因变量(生存=0，死亡=1)，以年龄(≤65岁=0，>65岁=1)，性别(女=0，男=1)，腹腔感染、血行性感染、脓毒症休克、机械通气、肾脏替代治疗、静脉补充Omega-3鱼油(赋值均为有=1，无=0)为自变量进行logistic回归分析，结果显示，男性、年龄大、血行性感染、机械通气支持、肾脏替代治疗是脓毒症患者90 d预后的危险因素，静脉补充Omega-3鱼油是脓毒症患者90 d预后的保护因素(表2)。经调整混杂因素(年龄、性别、血行性感染、机械通气、肾脏替代治疗)后，再进行logistic回归分析，结果显示，静脉补充Omega-3鱼油可有效降低脓毒症患者的死亡风险(OR=0.6，95%CI 0.5~0.8，P<0.001)。
2.3 Omega-3鱼油干预对脓毒症患者生存曲线的影响
以患者90 d死亡作为终点事件，1733例脓毒症患者中失访87例，随访1646例，随访率94.98%，死亡382例。生存分析结果显示，静脉补充Omega-3鱼油能提高脓毒症患者的90 d生存率(P<0.05，图1)。
3 讨论
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Omega-3鱼油主要通过4种机制调节宿主的炎症/免疫反应，即代谢成具有生物活性的抗炎性二十烷酸炎性介质，改变细胞膜脂筏，抑制核受体活化(特别是核因子-κB)，以及代谢为新的促分解及抗炎介质[7]。这些机制在脓毒症及严重疾病中可能是有益的。有研究表明，重症脓毒症患者早期静脉注射Omega-3鱼油可以改善其器官功能障碍且无不良反应[8-9]。因此，静脉注射Omega-3鱼油在减轻重症脓毒症患者的过度炎症反应及降低并发症发生率、病死率方面具有潜在的应用价值[8-9]。对于存在肠道功能障碍的脓毒症患者，Omega-3鱼油可以改善其T辅助细胞/诱导细胞及CD4/CD8的比率，并能降低病死率[10]。
由于Omega-3鱼油具有免疫调节作用，它对改善严重脓毒症Ⅲ度急性胃肠损伤患者的长期预后具有积极作用，特别是腹腔感染合并腹腔高压的患者可能获益更大[11]。
还有荟萃分析发现，富含Omega-3鱼油的肠外营养可将感染风险降低40%，将脓毒症的风险降低56%，并能缩短入住重症监护室(ICU)及住院时间约2 d。在具有肠外营养适应证的患者中，补充富含ω-3脂质乳剂的效果优于标准脂肪乳制剂[12-13]。也有研究表明，在饮食中添加Omega-3鱼油能降低机体抵抗病原体的能力[6]，增加了急性肺损伤(ALI)患者的死亡风险[14-15]。然而，这些研究存在异质性，研究人群(疾病种类、严重程度及人种)、样本量大小、补充Omega-3鱼油的剂量等方面均有明显差异。因此，对脓毒症患者使用Omega-3鱼油的安全性及临床效益尚未得出一致结论。
本课题组既往研究发现，Omega-3鱼油可改善严重脓毒症急性胃肠损伤患者的长期预后[11,16]。而且，Omega-3鱼油脂肪乳也能有效减轻脓毒症相关急性肾损伤的严重程度[17]。本研究发现，脓毒症患者生存组与死亡组的年龄，性别，肺部感染、腹腔感染、血行性感染患者比例，并发症，机械通气、肾脏替代治疗及Omega-3鱼油干预比例差异有统计学意义。回归分析结果显示，静脉补充Omega-3鱼油可有效降低脓毒症患者的死亡风险。生存分析显示，静脉补充Omega-3鱼油能提高脓毒症患者90 d生存率。本研究也有一定局限性：(1)研究对象为ICU脓毒症患者，这类患者群体异质性大；(2)为回顾性研究，证据说服力有限；(3)基于医院信息系统(HIS)获取患者数据，虽然数据量较大，但提取的数据信息有限，难以全面反映真实情况；(4)监测指标相对简单，病例数有限，可能存在偏倚，需进一步加大样本量进行验证。
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doi: 10.11855/j.issn.0577-7402.2022.04.0390
  • 接收时间：2021-06-21
  • 首发时间：2025-12-17
  • 出版时间：2022-04-28
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    深圳市人民医院重症医学科，广东深圳 518020

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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