Parenteral fish oil as monotherapy prevents essential fatty acid deficiency in parenteral nutrition-dependent patients.
Parenteral fish oil as monotherapy prevents essential fatty acid deficiency in parenteral nutrition-dependent patients.
复制标题
肠胃外鱼类作为单一疗法可防止肠胃外营养依赖性患者的必需脂肪酸缺乏。
DOI：
10.1097/mpg.0b013e3181bbf51e
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发表时间：
2010-02
影响因子：
2.9
通讯作者：
Puder M
中科院分区：
文献类型：
--
作者：
de Meijer VE;Le HD;Meisel JA;Gura KM;Puder M
使用鱼油乳剂作为接受肠外营养（PN）的患者的唯一脂肪来源，引起了对必需脂肪酸缺乏症（EFAD）发展的担忧，阻碍了其在临床实践中的应用。本研究的目的是检查未接受肠内热量，而完全依赖PN和静脉注射鱼油脂肪乳剂的患者的脂肪酸谱，以确定EFAD的发生和生长的维持。审查了从10名患者中收集的数据，以确定EFAD的证据，EFAD定义为三烯：四烯比大于0.2。将基线时身高、生长和头围的经年龄校正的Z评分与删失时的相应Z评分进行比较。所有患者均接受PN，以1 g.kg-1.day-1的鱼油脂肪乳剂作为脂肪热量的唯一来源，持续至少1个月。鱼油单药治疗是根据同情使用协议使用的。出生时的中位孕龄为35周，治疗开始时的中位年龄为3.5个月。在接受纯PN和鱼油脂肪乳剂治疗的中位时间为3.8个月后，无患者出现EFAD的生化或临床证据。Z评分无统计学差异，表明无生长障碍。9例患者的中位直接胆红素水平从6.8 mg/dL改善至0.9 mg/dL（P=0.009）。当剂量适当时，鱼油脂肪乳剂含有足量的必需脂肪酸，可预防EFAD并维持完全依赖PN的患者的生长。
The use of fish oil-based emulsions as the sole source of fat for patients receiving parenteral nutrition (PN) has raised concerns for the development of essential fatty acid deficiency (EFAD), hindering its adoption into clinical practice. The purpose of this study was to examine fatty acid profiles of patients receiving no enteral calories, while completely dependent on PN and an intravenous fish oil-based lipid emulsion, for onset of EFAD and maintenance of growth. Prospectively collected data from ten patients was reviewed for evidence of EFAD, defined as a triene:tetraene ratio greater than 0.2. Gestational age-adjusted Z-scores for length, growth and head circumference at baseline were compared to the corresponding Z-scores at time of censoring. All patients received PN with a fish oil-based lipid emulsion at 1 g.kg−1.day−1 as the sole source of fat calories for at least 1 month. The fish oil monotherapy was used under a compassionate use protocol. Median gestational age at time of birth was 35 weeks, and median age at the start of treatment was 3.5 months. After a median time of 3.8 months on exclusive PN and fish oil-based lipid emulsion, none of the patients developed biochemical or clinical evidence of EFAD. Z-scores were not statistically different, indicating no growth impairment. Median direct bilirubin levels improved in 9 patients from 6.8 mg/dL to 0.9 mg/dL (P=0.009). When dosed appropriately, fish oil-based lipid emulsions contain sufficient amounts of essential fatty acids to prevent EFAD and sustain growth in patients completely dependent on PN.