添加结构脂肪乳的肠外营养支持治疗方案疗效和安全性的Meta分析  

Meta-analysis on efficacy and safety of structured triglyceride in parenteral nutrition support treatment

作　　者：沈娟 孔薇 徐丙发 

机构地区：[1]安徽医科大学第三附属医院药学部,安徽合肥230061

出　　处：《中国新药与临床杂志》2016年第4期276-281,共6页Chinese Journal of New Drugs and Clinical Remedies

基　　金：安徽省"十二五"重点培育专科[皖卫科201255号]

摘　　要：目的采用Meta分析法比较添加结构脂肪乳和不添加结构脂肪乳的肠外营养支持治疗方案的疗效和安全性。方法检索Pub Med、EMBase、Cochrane Library、中国生物医学文献数据库、中国学术期刊全文数据库、万方数据库和维普数据库等文献资料,收集1990—2015年期间发表的使用添加结构脂肪乳的肠外营养液进行营养支持治疗的随机对照试验,按纳入、排除标准进行筛选并进行质量评价,应用Rev Man 5.3软件进行Meta分析。结果共纳入19篇(n=889)符合标准的随机对照试验相关文献。分析结果显示,与添加其他脂肪乳剂相比,使用添加结构脂肪乳的肠外营养支持治疗方案在提高血浆白蛋白水平[WMD=0.09,95%CI(0.03～0.15),P<0.05];减少对脂肪代谢的影响[WMD=-0.15,95%CI(-0.26～-0.03),P<0.05]等方面具有显著优势;在改善患者肝功能的指标方面,其对于降低丙氨酸转氨酶的水平具有显著优势[SMD=-0.64,95%CI(-1.21～-0.08),P<0.05]。其他指标如降低总胆红素[WMD=-1.95,95%CI(-4.10～0.20),P>0.05]及γ-谷氨酰转移酶水平[SMD=-0.10,95%CI(-1.05～0.84),P>0.05]等方面则不具有显著差异。结论添加结构脂肪乳的肠外营养支持治疗方案疗效优于添加其他脂肪乳剂,并可在一定程度上减少肠外营养使用对患者肝功能造成的损伤,是一种较为安全有效的治疗方法。AIM To compare the efficacy and safety of structured triglyceride（ STG） with other fatemulsions in parenteral nutrition support treatment. METHODS Databases including Pub Med, EMBase,Cochrane Library, Sino Med, CNKI, Wanfang, and VIP were searched from 1990—2015 for randomized controlled trials（ RCTs） focusing on structured triglyceride in parenteral nutrition support treatment. All the literatures retrieved were screened according to inclusion and exclusion criteria. The software Rev Man 5.3 was used for meta- analysis. RESULTS A total of 19 RCTs（ n = 889） met the inclusion criteria. The results of meta- analysis showed that compared with the other fat emulsions, the STG- containing parenteral nutrition mixture experienced an effective improvement in ALB level（WMD = 0.09, 95% CI（0.03- 0.15）, P〈 0.05）and reduced the influence on lipid metabolism（ WMD =-0.15, 95% CI（-0.26--0.03）, P 〈0.05）. The result also showed that it could improve liver function, especially on ALT（SMD =-0.64, 95% CI（-1.21--0.08）, P〈 0.05）. But there were no significant decreases in TB（WMD =-1.95, 95% CI（-4.10- 0.20）,P〉 0.05） and γ- GT（SMD =-0.10, 95% CI（-1.05-0.84）, P〉 0.05）. CONCLUSION The STG- containing parenteral nutrition support treatment has better curative effect than other fat emulsions with less injury on liver function, and is suitable for the patient who need parenteral nutrition support.

关 键 词：脂肪乳剂 静脉注射用 肠外营养溶液 随机对照试验 META分析 

分 类 号：R977.6[医药卫生—药品]