鱼油脂肪乳对脓毒症患者疗效的Meta分析  

Efficacy of Fish Oil Containing Lipid Emulsion in Sepsis:A Meta-Analysis

作　　者：林婷婷[1] 江梅[2] 黄勇波[2] 毛璞[2] 刘晓青[2] 闫凤[1] 张容[2] 黎毅敏[2] 

机构地区：[1]广州医科大学附属第一医院营养科,广东广州510120 [2]广州医科大学附属第一医院广州呼吸疾病研究所,广东广州510120

出　　处：《中国呼吸与危重监护杂志》2014年第2期162-169,共8页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的系统评价鱼油脂肪乳在脓毒症病程及预后中的作用和地位。方法计算机检索PubMed、EMBASE、FMJS、Cochrane图书馆临床对照试验资料库、CNKI、万方、维普等数据库自1980年至今发表的鱼油脂肪乳治疗脓毒症患者的随机对照试验相关文献。两名评价员独立筛查文献及质量评价、提取数据。采用Jadad量表法评估纳入文献的方法学质量。采用RevMan5.2软件对数据进行Meta分析。结果共纳入15篇研究,794例研究对象。鱼油组与对照组比较:①明显降低脓毒症患者的ICU住院天数[WMD=-5.59,95%CI(-7.65,-3.53)]、总住院天数[WMD=-10.48,95%CI(-14.67,-6.29)]、28 d病死率[RR=0.69,95%CI(0.52,0.93)];②明显降低肿瘤坏死因子α[WMD=31.78,95%CI(5.63,57.92)],明显提高氧合指数[WMD=41.95,95%CI(30.80,53.11)];③治疗后CRP比较,差异无统计学意义(P>0.05)。结论鱼油脂肪乳能显著减少脓毒症患者的ICU住院天数、住院总天数、28天病死率、TNF-α,改善氧合,但对于CRP降低幅度与传统脂肪乳相比无明显差别。结果表明鱼油脂肪乳治疗脓毒症可获益。Objective To evaluate the clinical efficacy of fish oil containing lipid emulsion （ FO）in sepsis.Methods Randomized controlled trials about fish oil containing lipid emulsion in sepsis, which were published from 1980, were searched from the following electronic databases： PubMed, Embase, Foreign Medical Journal Service, Cochrane Library, CNKI, Wanfang Database, and VIP Database. The articles screening, quality assessment and data extraction were conducted by two reviewers independently. The methodological quality of trials was assessed by Jadad’s scale. All data was analyzed by Review Manager 5. 2 software. Results Fifteen studies involving 794 participants met the inclusion criteria. The metaanalysis results were as follows： compared with the control group, ①FO could shorten the length of ICU stay[ WMD = - 5. 59,95% CI（ - 7. 65, - 3. 53） ] and the length of hospital stay [ WMD = - 10. 48, 95% CI （ - 14. 67, - 6. 29） ] , and also decrease the 28-day mortality [ RR = 0. 69, 95% CI（ 0. 52, 0. 93） ] . ②FO could reduce the concentration of TNF-α[ WMD =31. 78, 95% CI（ 5. 63,57. 92） ] and improve oxygenation index [ WMD =41. 95, 95% CI（ 30. 80, 53. 11） ] in septic patients. ③There was no statistical significance in the decrease of C-reactive protein （ CRP） between two groups （ P 〉 0. 05 ） . Conclusions The administration of FO in septic patients can significantly shorten the length of ICU stay and hospital stay,decrease the 28-day mortality, reduce the concentration of TNF-αand improve oxygenation index. However,it shows no significant difference in the decrease of CRP compared with the administration of traditional lipid emulsion. All of the above results show that the septic patients can benefit from the administration of fish oil containing lipid emulsion.

关 键 词：脓毒症 鱼油 Ω-3脂肪酸 脂肪乳 META分析 

分 类 号：R459.7[医药卫生—急诊医学]