目的：探讨静脉应用ω-3鱼油脂肪乳剂及乌司他丁对重症患者炎症反应、免疫调节功能及预后的影响。方法：将入住我院重症监护室（ICU）、急性生理学与慢性健康状况评分Ⅱ（APACHE Ⅱ）≥15分且有全胃肠外营养指征的75例患者随机分为对照组、鱼油组和乌司他丁组，每组25例。于治疗前及治疗第6天定期监测患者T淋巴细胞亚群（CD4+/CD8+）以及白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平，并对患者用药前后进行APACHEⅡ评分，同时记录患者ICU住院天数。结果：治疗第6天CD4+/CD8+值鱼油组显著高于对照组（P < 0.01）及乌司他丁组（P < 0.05）；同组治疗第6天与治疗前比较，鱼油组CD4+/CD8+值显著升高（P < 0.01）。治疗第6天IL-6水平鱼油组及乌司他丁组均低于对照组（P < 0.05）；同组治疗第6天与治疗前比较，鱼油组与乌司他丁组IL-6均显著降低（P < 0.01）。治疗第6天TNF-α水平鱼油组及乌司他丁组均显著低于对照组（P < 0.01）；同组治疗前与治疗第6天对比，鱼油组与乌司他丁组TNF-α水平均显著降低（P < 0.01）。治疗第6天鱼油组APACHEⅡ评分低于对照组及乌司他丁组（P < 0.05）；同组治疗前与治疗第6天对比，鱼油组与乌司他丁组APACHEⅡ显著下降（P < 0.01）。鱼油组及乌司他丁组ICU住院天数均短于对照组（P < 0.05）。结论：鱼油和乌司他丁均有较强的减少炎症介质生成、减轻炎症反应的作用，而鱼油相对于乌司他丁具有更强的提高机体免疫力、改善细胞免疫的作用。两药在重症患者的辅助治疗过程中具有良好安全性和耐受性。

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