Mechanisms for the effects of fish oil lipid emulsions in the management of parenteral nutrition-associated liver disease
Mechanisms for the effects of fish oil lipid emulsions in the management of parenteral nutrition-associated liver disease
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DOI：
10.1016/j.plefa.2013.02.008
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发表时间：
2013-09-01
影响因子：
3
通讯作者：
Puder, M.
中科院分区：
文献类型：
--
作者：
Nandivada, P.;Cowan, E.;Puder, M.
肠外营养（PN）可以挽救因肠道长度或功能不足导致肠衰竭而无法充分吸收肠内营养的婴儿的生命。然而，长期PN具有显著的发病率和死亡率，30 - 60%的患者发生进行性肝功能障碍。PN相关肝病（PNALD）的病因尚不清楚，但已明确脂肪乳剂参与其发病机制，新的重点是omega-6多不饱和脂肪酸和omega-3多不饱和脂肪酸的作用。最近评价使用胃肠外鱼油脂肪乳剂替代大豆油脂肪乳剂的研究表明，接受鱼油治疗的PNALD患者的胆汁淤积、发病率和死亡率显著改善。本综述概述了脂肪乳剂在PNALD发病机制中的作用，以及胃肠外鱼油脂肪乳剂可能发挥其有益作用的拟议机制。(c)2013爱思唯尔有限公司保留所有权利。
Parenteral nutrition (PN) can be life saving for infants unable to adequately absorb enteral nutrients due to intestinal failure from inadequate bowel length or function. However, long-term PN carries significant morbidity and mortality, with 30 to 60% of patients developing progressive liver dysfunction. The etiology of PN-associated liver disease (PNALD) is poorly understood, however the involvement of lipid emulsions in its pathogenesis has been clearly established, with new emphasis emerging on the role of omega-6 polyunsaturated fatty acids and omega-3 polyunsaturated fatty acids. Recent studies evaluating the use of parenteral fish oil lipid emulsions instead of soybean oil lipid emulsions have demonstrated marked improvements in cholestasis, morbidity, and mortality in patients with PNALD treated with fish oil. This review provides an overview of the role of lipid emulsions in the pathogenesis of PNALD and the proposed mechanisms by which parenteral fish oil lipid emulsions may be exerting their beneficial effects. (c) 2013 Elsevier Ltd. All rights reserved.