含鱼油脂肪乳剂预防早产儿肠外营养相关性胆汁淤积症的Meta分析

Meta-analysis on the prevention of parenteral nutrition associated cholestasis in preterm infants by fish oil lipid emulsions

目的通过Meta分析回顾和整合鱼油脂肪乳剂对肠外营养相关性胆汁淤积症(PNAC)的影响。方法通过检索Pub Med、Embase、Cochrane Library、万方和中国知网数据库,收集从各数据库创建时间至2021年3月公开发表的胃肠外营养含鱼油脂肪乳剂与PNAC的相关文献。采用Rev Man 5.4进行统计分析。结果共纳入20项研究,其中随机对照研究5篇,共计600例肠外营养早产儿,回顾性研究15篇,共计1 445例肠外营养早产儿。Meta分析结果显示,5项随机对照研究中含鱼油脂肪乳剂可减少PNAC的发生(RR=0.66,95%CI:0.46~0.95,Z=2.25,P<0.05);15项回顾性研究中含鱼油脂肪乳剂可减少PNAC的发生(OR=0.76,95%CI:0.63~0.93,Z=2.67,P<0.01)。结论含鱼油脂肪乳剂可有效预防早产儿肠外营养相关的胆汁淤积症。

Objective To systematically review and integrate the outcome of fish oil lipid emulsions in the prevention on parenteral nutrition associated cholestasis( PNAC) through mate-analysis. Methods Through retrieving Pub Med,Embase,Cochrane Library,Wanfang and CNKI databases,the literatures about fish oil lipid emulsions and PNAC published from inception to March,2021 were collected. Statistical analysis was performed by Rev Man 5. 4 software. Results Twenty literatures were included,including 5 RCT studies containing 600 preterm infants and and 15 retrospective studies containing1 445 preterm infants. Meta-analysis results showed that fish oil lipid emulsions reduced the incidence of PNAC( RR = 0. 66,95% CI: 0. 46 ~ 0. 95,Z = 2. 25,P < 0. 05) in in the 5 RCT studies,and reduced the incidence of PNAC( OR = 0. 76,95%CI: 0. 63 ~ 0. 93,Z = 2. 67,P < 0. 01) in the 15 retrospective studies. Conclusion Parenteral fish oil lipid emulsions could effectively prevent the PNAC in premature infants.