Effect of an Olive Oil-Based Lipid Emulsion Compared With a Soybean Oil-Based Lipid Emulsion on Liver Chemistry and Bile Acid Composition in Preterm Infants Receiving Parenteral Nutrition: A Double-Blind, Randomized Trial.
Effect of an Olive Oil-Based Lipid Emulsion Compared With a Soybean Oil-Based Lipid Emulsion on Liver Chemistry and Bile Acid Composition in Preterm Infants Receiving Parenteral Nutrition: A Double-Blind, Randomized Trial.
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DOI：
10.1177/0148607114566853
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发表时间：
2016-08
期刊：
影响因子：
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通讯作者：
Ying Wang;Kejun Zhou;Q. Tang;L. Hong;Yi Feng;Li-na Lu;Weipeng Wang;W. Cai
中科院分区：
文献类型：
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作者：
Ying Wang;Kejun Zhou;Q. Tang;L. Hong;Yi Feng;Li-na Lu;Weipeng Wang;W. Cai
背景：肠外营养(PN)相关性肝功能障碍的发病机制是多因素的。脂肪乳剂可能是其作用机制之一。我们的目的是比较评估以橄榄油和大豆油为基础的非肠道脂肪乳剂对早产儿肝脏化学和胆汁酸组成的影响。方法采用随机双盲临床研究方法，将103例早产儿随机分为两组：大豆油型脂肪乳剂(SO；n=51)和橄榄油(OO)脂肪乳剂(OO；n=52)。主要终点是肝脏的化学成分。次要终点是血浆胆汁酸成分。结果100名婴幼儿完成本研究。SO组肠外营养7d后血清直接胆红素水平明显高于OO组。两个治疗组的胆汁酸都随着时间的推移而增加。然而，随着时间的推移，胆汁酸成分的变化在不同组之间有具体的差异。结论两组患者的直接胆红素和胆汁酸组成随时间变化存在差异。考虑到高危婴儿长期使用脂肪乳剂，这些发现可能有助于理解PN相关性肝功能障碍的发病机制。
BACKGROUND The pathogenesis of parenteral nutrition (PN)-associated liver dysfunction is multifactorial. Lipid emulsions may be one of the putative mechanisms. Our aim was to comparatively assess the effect of parenteral olive oil- and soybean oil-based lipid emulsions on liver chemistry and bile acid composition in preterm infants. METHODS We performed a double-blind, randomized clinical study in which 103 preterm infants were randomly assigned to PN using either soybean oil-based lipid emulsion (SO; n = 51) or olive oil (OO)-based lipid emulsion (OO; n = 52). The primary end point was liver chemistry. The secondary end point was the plasma bile acid composition. RESULTS One hundred infants completed this study. In the SO group, the serum direct bilirubin was significantly higher after PN for 7 days compared with the OO group. Bile acids increased over time in both treatment groups. However, specific differences in the change in bile acid composition over time were noted between groups. CONCLUSIONS Differences in direct bilirubin and bile acid composition were observed over time between the 2 groups. Considering the long-term use of lipid emulsions in higher risk babies, these findings might be useful for understanding the pathogenesis of PN-associated liver dysfunction.