中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
22期
9-11
,共3页
幸泽茂%熊丽红%张宪华%郑晓英
倖澤茂%熊麗紅%張憲華%鄭曉英
행택무%웅려홍%장헌화%정효영
脓毒症%脂肪酸类,不饱和%心肌%氧化性应激
膿毒癥%脂肪痠類,不飽和%心肌%氧化性應激
농독증%지방산류,불포화%심기%양화성응격
Sepsis%Fatty acids,unsaturated%Myocardium%Oxidative stress
目的 探讨ω-3多不饱和脂肪酸对重症脓毒症患者心肌损伤的保护作用.方法 31例重症脓毒症患者按随机数字表法分为治疗组(17例)和对照组(14例).两组均应用等氮、等热量肠内及肠外混合营养治疗5d.治疗组采用10％鱼油脂肪乳注射液+中长链脂肪乳,对照组采用中长链脂肪乳.观察比较两组治疗前1d及治疗5d后血清丙二醛(MDA)、超氧化物歧化酶(SOD)、心肌肌钙蛋白Ⅰ (cTnI)、N-末端B型尿钠肽前体(NT-proBNP)水平和急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分.结果 治疗前1d两组各项指标比较差异无统计学意义(P＞0.05).两组治疗5d后MDA、cTnI、NT-proBNP、APACHEⅡ评分均较治疗前1d降低,SOD升高,差异均有统计学意义(P＜0.05);且治疗组治疗5d后MDA、SOD、cTnI、NT-proBNP较对照组改善更明显[(7.50±2.06)mmol/L比(9.24±1.79)mmol/L、(89.22±16.21) mU/L比(76.60±15.13) mU/L、(0.65±0.34) μg/L比(1.03±0.62) μg/L、(1267.13±279.26) ng/L比(1532.47±375.73) ng/L],差异有统计学意义(P＜0.05).两组治疗5d后APACHEⅡ评分比较差异无统计学意义(P＞0.05).结论 ω-3多不饱和脂肪酸能够减轻重症脓毒症患者氧化应激反应,减轻心肌损伤,降低cTnI及NT-proBNP水平,改善心功能.
目的 探討ω-3多不飽和脂肪痠對重癥膿毒癥患者心肌損傷的保護作用.方法 31例重癥膿毒癥患者按隨機數字錶法分為治療組(17例)和對照組(14例).兩組均應用等氮、等熱量腸內及腸外混閤營養治療5d.治療組採用10％魚油脂肪乳註射液+中長鏈脂肪乳,對照組採用中長鏈脂肪乳.觀察比較兩組治療前1d及治療5d後血清丙二醛(MDA)、超氧化物歧化酶(SOD)、心肌肌鈣蛋白Ⅰ (cTnI)、N-末耑B型尿鈉肽前體(NT-proBNP)水平和急性生理學與慢性健康狀況Ⅱ(APACHEⅡ)評分.結果 治療前1d兩組各項指標比較差異無統計學意義(P＞0.05).兩組治療5d後MDA、cTnI、NT-proBNP、APACHEⅡ評分均較治療前1d降低,SOD升高,差異均有統計學意義(P＜0.05);且治療組治療5d後MDA、SOD、cTnI、NT-proBNP較對照組改善更明顯[(7.50±2.06)mmol/L比(9.24±1.79)mmol/L、(89.22±16.21) mU/L比(76.60±15.13) mU/L、(0.65±0.34) μg/L比(1.03±0.62) μg/L、(1267.13±279.26) ng/L比(1532.47±375.73) ng/L],差異有統計學意義(P＜0.05).兩組治療5d後APACHEⅡ評分比較差異無統計學意義(P＞0.05).結論 ω-3多不飽和脂肪痠能夠減輕重癥膿毒癥患者氧化應激反應,減輕心肌損傷,降低cTnI及NT-proBNP水平,改善心功能.
목적 탐토ω-3다불포화지방산대중증농독증환자심기손상적보호작용.방법 31례중증농독증환자안수궤수자표법분위치료조(17례)화대조조(14례).량조균응용등담、등열량장내급장외혼합영양치료5d.치료조채용10％어유지방유주사액+중장련지방유,대조조채용중장련지방유.관찰비교량조치료전1d급치료5d후혈청병이철(MDA)、초양화물기화매(SOD)、심기기개단백Ⅰ (cTnI)、N-말단B형뇨납태전체(NT-proBNP)수평화급성생이학여만성건강상황Ⅱ(APACHEⅡ)평분.결과 치료전1d량조각항지표비교차이무통계학의의(P＞0.05).량조치료5d후MDA、cTnI、NT-proBNP、APACHEⅡ평분균교치료전1d강저,SOD승고,차이균유통계학의의(P＜0.05);차치료조치료5d후MDA、SOD、cTnI、NT-proBNP교대조조개선경명현[(7.50±2.06)mmol/L비(9.24±1.79)mmol/L、(89.22±16.21) mU/L비(76.60±15.13) mU/L、(0.65±0.34) μg/L비(1.03±0.62) μg/L、(1267.13±279.26) ng/L비(1532.47±375.73) ng/L],차이유통계학의의(P＜0.05).량조치료5d후APACHEⅡ평분비교차이무통계학의의(P＞0.05).결론 ω-3다불포화지방산능구감경중증농독증환자양화응격반응,감경심기손상,강저cTnI급NT-proBNP수평,개선심공능.
Objective To investigate the protective effects of ω-3 polyunsaturated fatty acids on severe sepsis patients with myocardial injury.Methods Thirty-one patients with severe sepsis were divided into treatment group (17 cases) and control group (14 cases) by random digits table.All patients received partial enteral nutrition and partial parenteral nutrition with equivalent nitrogen and calorie values for 5 days.The control group was given routine therapy and the treatment group was given routine therapy and ω-3 polyunsaturated fatty acids emulsion.The serum malondialdehyde (MDA),superoxide dismutase (SOD),cardiac troponin Ⅰ(cTnI),N-terminal pro-B urine sodium peptide (NT-proBNP) levels and acute physiology and chronic health evaluation (APACHE) Ⅱ score was compared between two groups before and after treatment.Results There was no difference in indicators before treatment between two groups (P ＞ 0.05).The MDA,cTnI,NT-proBNP and APACHE Ⅱ score in two groups after treatment 5 days was lower than that before treatment 1 day,and the SOD was higher than that before treatment (P ＜ 0.05).The MDA,SOD,cTnI and NT-proBNP after treatment 5 days in treatment group was better than that in control group [(7.50 ±2.06) mmol/L vs.(9.24 ± 1.79) mmol/L,(89.22 ± 16.21) mU/L vs.(76.60 ± 15.13) mU/L,(0.65 ± 0.34)μ g/L vs.(1.03 ± 0.62) μ g/L,(1267.13 ± 279.26) ng/L vs.(1532.47 ± 375.73) ng/L],and there was significant difference between two groups (P ＜ 0.05).The APACHE Ⅱ score was no significant difference between two groups after treatment 5 days.Conclusion ω-3 polyunsaturated fatty acids can reduce the oxidative stress and myocardial injury,decrease cTnI and NT-proBNP levels and improve heart function in the patients with severe sepsis.
