静脉补充Omega-3多不饱和脂肪酸对脓毒症患者临床结局影响的系统评价与荟萃分析  

Effect of intravenous omega-3 fatty acids on outcome of patients with sepsis:a systematic review and meta-analysis

作　　者：杨广宇 王璐 王宇 张驰 曾俊 江华[1,2] 孙明伟 Yang Guangyu;Wang Lu;Wang Yu;Zhang Chi;Zeng Jun;Jiang Hua;Sun Mingwei(School of Medicine,University of Electronic Science and Technology of China,Chengdu 610054,China;Institute for Emergency and Disaster Medicine,Emergency Center,Sichuan Provincial People′s Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610072,China)

机构地区：[1]电子科技大学医学院,成都610054 [2]四川省医学科学院、四川省人民医院(电子科技大学附属医院)急诊医学与灾难医学研究所急救中心,成都610072

出　　处：《中华损伤与修复杂志（电子版）》2023年第2期148-156,共9页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：四川省科技计划资助(2021YFS0378、2021YFH0109、2020YFS0392);四川省人民医院基金(2021ZX01)。

摘　　要：目的通过系统评价和荟萃分析探索静脉补充Omega-3脂肪酸对脓毒症患者临床结局的影响。方法使用知网、万方、SinoMed、PubMed、EMBase、Web of Science、Cochrane Library等电子数据库,检索相关临床随机对照试验。时间范围为2000年1月1日至2023年1月31日。主要结局为28天病死率,次要结局为住ICU时间、住院时间以及机械通气时间。采用改良Jadad评分量表评价研究质量,Cochrane偏倚风险评估工具评估偏倚风险,GRADE证据分级方法评价证据强度。使用RevMan 5.4软件处理分析数据。结果初步筛选获得46篇相关文献,经过系统筛选,最终纳入5个RCT研究,共包含266例患者。对这些研究合并进行分析,结果表明与常规治疗组相比,静脉补充Omega-3脂肪酸组患者28天病死率显著降低[RR=0.52,95%CI(0.33,0.83),P=0.006];住ICU天数显著减少[MD=-4.40,95%CI(-8.68,-0.13),P=0.04];但两组患者接受机械通气时间差异无统计学意义[MD=-1.29,95%CI(-3.70,1.13),P=0.30]。结论通过静脉输注Omega-3多不饱和脂肪酸可以有效降低脓毒症患者病死风险并且减少患者ICU住院时间,对改善脓毒症患者的临床结局有积极作用,但其对患者接受机械通气时间的影响不显著。Objective To systematically review the clinical efficacy of intravenous omega-3 fatty acids supplemented for septic patients.Methods The relevant randomized controlled trails(RCTs)from 1 January 2000 to 31 January 2023 were searched in online databases,including CNKI,WanFang Data,SinoMed,PubMed,EMBase,Web of Science and Cochrane Library.The primary outcome was the 28-day mortality.The secondary outcome included the length of ICU stay,the length of hospital stays and the length of mechanical ventilation.The quality of these included studies was evaluated by the modified Jadad score scale.The bias was assessed by the Cochrane risk-of-bias tool for randomized trial.The data was analyzed using RevMan 5.4.Results Forty-six relevant literatures were obtained from initial literature retrieve and were screened systematically after preliminary screening.A total of 5 RCT studies involving 266 patients met all inclusion criteria and were enrolled systematic review.Meta-analysis indicated that intravenous administration of omega-3 fatty acids reduced the 28-day mortality[RR=0.52,95%CI(0.33,0.83),P=0.006].And the length of ICU stay was reduced for patients received intravenous omega-3 fatty acids[MD=-4.40,95%CI(-8.68,-0.13),P=0.04].In addition,there was no difference on the duration of mechanical ventilation between the two groups[MD=-1.29,95%CI(-3.70,1.13),P=0.30].Conclusion Intravenous supplementation of omega-3 fatty acids effectively reduce short-term mortality of patients with sepsis,shorten the length of stay in ICU,which has a positive effect on improving the clinical outcome of patients with sepsis,but its impact on the duration of mechanical ventilation is not significant.

关 键 词：Omega-3多不饱和脂肪酸 静脉输注 脓毒症 肠外 荟萃分析 系统评价 

分 类 号：R459.7[医药卫生—急诊医学]