n-3 PUFAs对类风湿关节炎患者影响的随机对照试验

EFFECTS OF FISH OIL ON RHEUMATOID ARTHRITIS-RANDOMIZED,DOUBLE-BLIND,PARALLEL TRIAL

目的研究富含n-3多不饱和脂肪酸(n-3 PUFAs)的鱼油对类风湿关节炎(rheumatoid arthritis,RA)病人的影响。方法将确诊为RA的60个病人随机分为大豆油组(大豆油胶囊)和鱼油组(鱼油胶囊,含EPA1.8+DHA1.2g/d),干预12w,干预期间对所有对象进行膳食教育,观察干预前后的临床表现,风湿、类风湿、血糖、血脂和免疫等指标,通过计算得出直观模拟标度尺疼痛评分(VAS)、疾病活动度评分(DAS28)和健康评估问卷(HAQ)。结果鱼油组VAS评分显著增加(P=0.048),DAS28评分、晨僵时间(,MST)、血沉(ESR)均明显降低(PDAS28=0.018,PMST=0.003,PESR=0.044),血清甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平也下降(PTG=0.027,PLDL=0.001)。结论鱼油(EPA1.8g+DHA1.2g/d)干预RA患者12w,可改善RA患者病情,并可显著降低RA病人的血脂水平。

Objective To study the effect of fish oil rich in n-3 polyunsturated fatty acids（n-3 PUFAs） on rheumatoid arthritis（RA） patients.Method In the placebo-controlled,double-blind,prospective study,60 RA subjects were randomly allocated to consume daily a nutritional supplement of 6 gram oil capsules containing either soybean oil or fish oil,which contained eicosapentaenoic acid（EPA） 1.8g and docosahexaenoic acid（DHA） 1.2g for 12 w.The clinical picture,rheumatoid indices,blood glucose,blood lipid and immune indices were measured.Visual analogue scale pain score（VAS）,disease activity score 28（DAS 28） and health assessment questionnaire（HAQ） were calculated.Results：In fish oil group,VAS of RA patients was significantly increased（P=0.048）,while DAS28,morning stiffness time（MST） and erythrocyte sedimentation rate（ESR） were significantly reduced（PDAS28=0.018,PMST =0.003,PESR=0.044）.Serum riacylglycerol（TG） and low density lipoprotein cholesterol（LDL-C） were also significantly decreased（PTG=0.027,PLDL=0.001）.Conclusion：The intervention of fish oil,containing EPA 1.8g/d and DHA 1.2g/d for 12 w is beneficial to RA patients whose serium TG and LDL-C were reduced.