富含鱼油的肠内营养制剂对脓毒症病人血清游离脂肪酸谱的影响  

Effects of enteral nutrition rich in fish oil on serum free fatty acid spectrum in patients with sepsis

作　　者：王玺[1] 管军[1] 林兆奋[1] 

机构地区：[1]第二军医大学附属长征医院急救科,上海200003

出　　处：《肠外与肠内营养》2015年第1期10-12,共3页Parenteral & Enteral Nutrition

摘　　要：目的：初步观察短期使用富含鱼油的肠内营养（EN）制剂对脓毒症病人血清游离脂肪酸谱的影响。方法：根据本组10例脓毒症病人对EN的耐受程度,经鼻胃管或鼻空肠管持续滴入瑞能200～1 000 ml/d,共6 d。使用气相色谱-质谱联用（GC-MS）法定量检测瑞能使用前和使用6 d后血清中27种游离脂肪酸的水平。结果：除二十碳五烯酸（EPA,C20：5n3）和花生四烯酸（AA,C20：4n6）外,其余25种游离脂肪酸水平未出现明显的变化。使用瑞能6 d后,所有病人的EPA水平均增加,平均从（13.87±18.58）mg/L增加至（38.95±28.74）mg/L,（P=0.002）。EPA增加的绝对值与瑞能使用量呈显著性正相关。血清AA水平8例下降,2例升高。平均从（324.10±165.66）mg/L下降至（222.03±99.34）mg/L,P=0.011。瑞能使用量与AA变化的绝对值没有相关关系（P=0.376）。结论：脓毒症病人使用瑞能6 d后,血清中EPA的水平显著增加,并且与其使用剂量直接相关,同时AA水平显著下降。Objective： The study is to observe the effects of enteral nutrition rich in fish oil in short-term use on serum free fatty acid spectrum in patients with sepsis. Methods： According to the tolerance of enteral nutrition,the patients were given Supportan by nasal gastric tube or nasal jejunal tube,with the amount of 200 ～ 1 000 ml / d for 6 days. The serum levels of 27 kinds of free fatty acids were detected by gas chromatograph-mass spectrometer before and after using Supportan for 6 days.Results： Except the EPA（ C20： 5n3） and arachidonic acid（ C20： 4n6）,the levels of the other 25 kinds of free fatty acid showed no statistically significant difference. After Supportan was used,the levels of EPA in all patients were increased from（ 13. 87 ± 18. 58） mg / L to（ 38. 95 ± 28. 74） mg / L（ P =0. 002）. The absolute increased value of EPA was significantly associated with the usage of Supportan.The serum levels of arachidonic acid in 8 cases were decreased,while those in another 2 cases were increased. The average level was decreased from（ 324. 10 ± 165. 66） mg / L to（ 222. 03 ± 99. 34） mg / L（ P = 0. 011）. The usage of Supportan was not associated with absolute value of the change of arachidonic acid（ P = 0. 376,P = 0. 528）. Conclusion： The use of Supportan can increase the serum level of EPA in patients with sepsis.

关 键 词：Ω-3多不饱和脂肪酸 二十碳五烯酸 花生四烯酸 肠内营养 脓毒症 

分 类 号：R459.7[医药卫生—急诊医学]