FISH-OIL FATTY-ACID SUPPLEMENTATION IN ACTIVE RHEUMATOID-ARTHRITIS - A DOUBLE-BLINDED, CONTROLLED, CROSSOVER STUDY
FISH-OIL FATTY-ACID SUPPLEMENTATION IN ACTIVE RHEUMATOID-ARTHRITIS - A DOUBLE-BLINDED, CONTROLLED, CROSSOVER STUDY
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DOI：
10.7326/0003-4819-106-4-497
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发表时间：
1987-04-01
影响因子：
39.2
通讯作者：
LININGER, L
中科院分区：
文献类型：
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作者：
KREMER, JM;JUBIZ, W;LININGER, L
确定鱼油膳食补充剂对活动性类风湿关节炎的功效及其对中性粒细胞白三烯水平的影响。非随机、双盲、安慰剂对照、交叉试验，治疗期为 14 周，清除期为 4 周。学术医疗中心、转诊风湿病诊所。四十名患有活动性、明确性或典型类风湿性关节炎的志愿者。五名患者退出，两名患者因不遵守规定而被移除。继续使用非类固醇抗炎药、慢效抗风湿药和泼尼松治疗。 21 名患者开始每日服用 15 粒 MAX-EPA 胶囊（R.P Scherer，克利尔沃特，佛罗里达州），每日剂量为 2.7 克二十碳五烯酸和 1.8 克二十二碳六烯酸，另外 19 名患者开始服用外观相同的安慰剂。背景饮食没有改变。 14 周后，鱼油优于安慰剂的结果如下：平均出现疲劳的时间缩短了 156 分钟（95% 置信区间，1.2 至 311.0 分钟），触痛关节数量减少 3.5 个（95% Cl，-6.0 至 -1.0）。其他临床指标也有利于鱼油，但未达到统计学显着性。中性粒细胞白三烯 B4 的产生与压痛关节数量的减少相关（Spearman 等级相关性 r = 0.53；p < 0.05）。血红蛋白水平、沉降率或类风湿因子压力或患者报告的不良反应没有统计学上的显着差异。鱼油的作用在 4 周的清除期之后仍然持续存在。摄入鱼油可主观缓解活动性类风湿性关节炎并减少嗜神经细胞白三烯 B4 的产生。需要进一步的研究来阐明鱼油补充剂的作用机制以及最佳剂量和持续时间。
To determine the efficacy of fish-oil dietary supplements in active rheumatoid arthritis and their effect on neutrophil leukotriene levels. Nonrandomized, double-blind, placebo-controlled, crossover trial with 14-week treatment periods and 4-week washout periods. Academic medical center, referral-based rheumatology clinic. Forty volunteers with active, definite, or classical rheumatoid arthritis. Five patients dropped out, and two were removed for noncompliance. Treatment with nonsteroid anti-inflammatory drugs, slow-acting antirheumatic drugs, and prednisone was continued. Twenty-one patients began with a daily dosage of 2.7 g of eicosapaentanoic acid in 1.8 g of docosahexenoic acid given in 15 MAX-EPA capsules (R.P Scherer, Clearwater, Florida), and 19 began with identical-appearing placebos. The background diet was unchanged. The following results favored fish oil over placebo after 14 weeks: mean time to onset of fatigue improved by 156 minutes (95% confidence intervals, 1.2 to 311.0 minutes), and number of tender joints decreased by 3.5 (95% Cl, -6.0 to -1.0). Other clinical measures favored fish oil as well but did not reach statistical significance. Neutrophil leukotriene B4 production was correlated with the decrease in number of tender joints (Spearman rank correlation r = 0.53; p < 0.05). There was no statistically significant differences in hemoglobin level, sedimentation rate, or pressure of rheumatoid factor or in patient-reported adverse effects. An effect from the fish oil persisted beyond the 4-week washout period. Fish-oil ingestion results in subjective alleviation of active rheumatoid arthritis and reduction in neurtorphil leukotriene B4 production. Further studies are needed to elucidate mechanisms of action and optimal dose and duration of fish-oil supplementation.