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富含 n-3PUFA 的脂肪乳与橄榄油脂肪乳对术后危重症成人氧化应激和炎症反应的比较:一项随机对照试验的二次分析。

Comparison of n-3 PUFA-Enriched vs. Olive-Oil-Based Lipid Emulsion on Oxidative Stress and Inflammatory Response in Critically Ill Post-Surgery Adults: Secondary Analysis of a Randomized Controlled Trial.

机构信息

Faculty of Pharmacy and Nutrition, Campus de Los Jerónimos, Universidad Católica San Antonio de Murcia, Guadalupe, 30107 Murcia, Spain.

Intensive Care Unit, Hospital General Universitario Reina Sofía, Avda Intendente Jorge Palacios 1, 30003 Murcia, Spain.

出版信息

Int J Mol Sci. 2024 Oct 31;25(21):11739. doi: 10.3390/ijms252111739.

DOI:10.3390/ijms252111739
PMID:39519287
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11546187/
Abstract

Malnutrition in critically ill patients represents a major concern as it can lead to adverse outcomes including increased morbidity and mortality. These patients exhibit an impaired immune response accompanied by increased oxidative stress. Nutritional support, including parenteral nutrition (PN), is critical in these patients. Intravenous lipid emulsions (ILEs), a key component of PN, provide energy and intervene in the modulation of inflammation. This was a secondary study of a randomized clinical trial at the Reina Sofia University Hospital (Murcia, Spain) for critically ill patients following major abdominal surgery that were administered PN supplemented with olive-oil-based ILE (OO-ILE, = 29) or a mixed-lipid ILE (soybean oil, medium chain triglycerides, OO and fish oil, SMOF-ILE, = 25). The effects on clinical outcomes, metabolic markers, oxidative stress, and inflammation were evaluated. No significant differences were observed between groups in the clinical parameters and outcomes, oxidative stress, or inflammatory markers. The within-group evaluation demonstrated an increase in total antioxidant capacity in both groups, while OO-ILE increased the levels of 15-F2t-isoprostane. In addition, the results showed that both mixtures reduced the release of IL-1β and IL-6. These findings suggest that both treatments had similar effects on oxidative stress and inflammatory response in this type of patient.

摘要

危重症患者的营养不良是一个主要关注点,因为它可能导致不良后果,包括发病率和死亡率增加。这些患者表现出免疫反应受损,同时伴有氧化应激增加。营养支持,包括肠外营养(PN),对这些患者至关重要。静脉内脂肪乳剂(ILE)是 PN 的一个关键组成部分,提供能量并干预炎症的调节。这是西班牙穆尔西亚雷纳索菲娅大学医院(西班牙穆尔西亚)对大型腹部手术后接受 PN 补充橄榄油基 ILE(OO-ILE,n = 29)或混合脂质 ILE(大豆油、中链甘油三酯、OO 和鱼油,SMOF-ILE,n = 25)的危重症患者进行的一项随机临床试验的二次研究。评估了对临床结局、代谢标志物、氧化应激和炎症的影响。两组间在临床参数和结局、氧化应激或炎症标志物方面无显著差异。组内评估显示两组的总抗氧化能力均增加,而 OO-ILE 增加了 15-F2t-异前列烷的水平。此外,结果表明,两种混合物均减少了 IL-1β和 IL-6 的释放。这些发现表明,这两种治疗方法对这类患者的氧化应激和炎症反应都有类似的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec5/11546187/36d06a843e4f/ijms-25-11739-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec5/11546187/2c0cddec90fb/ijms-25-11739-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec5/11546187/12e9ee1edea6/ijms-25-11739-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec5/11546187/36d06a843e4f/ijms-25-11739-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec5/11546187/2c0cddec90fb/ijms-25-11739-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec5/11546187/12e9ee1edea6/ijms-25-11739-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec5/11546187/36d06a843e4f/ijms-25-11739-g003.jpg

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本文引用的文献

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因此,在接受肠外营养的危重症儿童中,SO、MCT、OO、FO - ILE比SO - ILE具有更好的副作用特征。
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