摘要
目的了解多种油脂肪乳对ICU患者肝功、免疫功能及炎症的影响。方法将84例ICU患者采用随机数字表法分成试验组和对照组,每组42例。对照组给予肠内营养+肠外营养,肠外营养中脂肪乳类型为中长链脂肪乳;试验组同样给予肠内营养+肠外营养,肠外营养中脂肪乳类型为多种油脂肪乳。两组患者能量和蛋白质摄入基本相似,两组营养支持时间7 d。结果与对照组相比,试验组肝功能中总胆红素[(22.2±5.5)vs(31.3±7.4)μmol/L,P<0.05]明显偏小;免疫指标中CD4[(442.3±31.4)vs(322.1±23.7),P<0.05]、CD8[(289.7±23.4)vs(223.1±16.6),P<0.05]均明显上升;炎症标志物中CRP[(58.2±8.4)vs(83.7±17.1)mg/L,P<0.05]、IL-6[(36.9±5.2)vs(45.2±9.1)pg/mL,P<0.05]、IL-8[(46.1±8.4)vs(53.7±9.5)pg/mL,P<0.05]明显偏小。结论多种油脂肪乳能增强ICU患者免疫功能,减轻炎症反应,降低肝功能损害(尤其在减轻胆汁淤积方面),值得临床推广和应用。
Objective To investigate the effects of multi-oil fat emulsion injection on liver function, immune function and inflammation in intensive care unit(ICU) patients. Methods Eighty-four ICU patients admitted in the Department of Pulmonary and Critical Care Medicine of our hospital from June 2017 to September 2018 were prospectively recruited in this study. They were randomly divided into experimental group(n=42) and control group(n=42). The patients of both groups were given enteral nutrition+parenteral nutrition, and the fat emulsion was medium-long chain fat emulsion in the control group, and multi-oil fat emulsion in the experimental group. The energy and protein intake were basically similar in the patients of the 2 groups, and the nutritional support time was 7 days. Results The experimental group had significantly lower content of total bilirubin(22.2±5.5 vs 31.3±7.4 μmol/L, P<0.05), increased counts of CD4 cells(442.3±31.4 vs 322.1±23.7, P<0.05) and CD8 cells(289.7±23.4 vs 223.1±16.6, P<0.05), and decreased levels of CRP(58.2±8.4 vs 83.7±17.1 mg/L, P<0.05), IL-6(36.9±5.2 vs 45.2±9.1 pg/mL, P<0.05) and IL-8(46.1±8.4 vs 53.7±9.5 pg/mL, P<0.05) when compared with the control group. Conclusion Multi-oil fat emulsion injection enhances immune function, reduces inflammatory responses and attenuates liver damage(especially for cholestasis), and it is worthy of clinical promotion and application.
作者
朱文艺
樊荣
李利
王翔宇
徐静
胡明冬
李琦
王建
ZHU Wenyi;FAN Rong;LI Li;WANG Xiangyu;XU Jing;HU Mingdong;LI Qi;WANG Jian(Department of Nutritionl,Army Medical University(Third Military Medical University),Chongqing,400037,China;Department of Pulmonary and Critical Care Medicine,Second Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,400037,China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2020年第3期273-277,共5页
Journal of Third Military Medical University
关键词
多种油脂肪乳
重症患者
肝功能
免疫功能
炎症反应
multi-oil fat emulsion injection
critically ill patients
liver function
immune function
inflammatory response
