ω-3多不饱和脂肪酸治疗非酒精性脂肪性肝病的Meta分析  

ω-3 Polyunsaturated fatty acids for treatment of non-alcoholic fatty liver disease: A systematic review of randomized controlled trials

作　　者：何继东[1] 朱毓江 刘莉[1] Ji-Dong He Yu-Jiang Zhu Li Liu(Department of Endocrinology, the Second People＇s Hospital of Ya＇an City, Ya＇an 625000, Sichuan Province, Chin)

机构地区：[1]雅安市第二人民医院内分泌科,四川省雅安市625000

出　　处：《世界华人消化杂志》2017年第27期2459-2468,共10页World Chinese Journal of Digestology

摘　　要：目的系统评价ω-3多不饱和脂肪酸(omega-3 polyunsaturated fatty acids,ω-3PUFA)治疗非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的疗效和安全性.方法电子检索Cochrane图书馆临床对照试验、PubMed、EMBASE、CNKI、VIP、万方期刊论文数据库等,检索时限为建库至2017-01.并手检相关会议论文集及查阅参考文献,全面收集国内外关于ω-3PUFA治疗NAFLD的随机对照试验研究资料进行系统评价.结果共纳入11个试验(743例)患者.Meta分析结果:(1)肝脏组织学改善有效率:ω-3PUFA组优于安慰剂或空白对照组(OR=2.64,95%CI:1.36-5.14;P=0.004);(2)肝脏生化学指标(谷丙转氨酶、谷草转氨酶、谷氨酰转肽酶):ω-3PUFA组优于安慰剂或空白对照[95%CI:-15.77-(-2.91);P=0.004]、[95%CI:-14.79-(-1.94);P=0.01]、[95%CI:-21.33-(-6.92);P=0.0001];(3)血脂指标(甘油三酯、总胆固醇、低密度脂蛋白):ω-3PUFA组优于安慰剂或空白对照组[95%CI:-2.38-(-0.21);P=0.02]、[95%CI:-1.71-(-0.06);P=0.04]、[95%CI:-0.53-(-0.23);P<0.00001].结论ω-3PUFA治疗非酒精性脂肪性肝病可改善肝脏组织学和肝脏酶谱,同时改善血脂,是一种安全有效的辅助治疗方案.但仍需高质量循证医学证据指导临床.AIM To assess the efficacy and safety of ω-3 polyunsaturated fatty acids（ω-3 PUFAs） for the treatment of non-alcoholic fatty liver disease.METHODS We searched Cochrane Central Register of Controlled Trails（CENTRAL）, PubMed, EMBASE, CNKI, VIP, Wanfang database before January 2017, and the relevant conference proceedings to retrieve randomized controlled trials that assessed the efficacy and safety of ω-3 PUFAs for the treatment of non-alcoholic fatty liver disease. The systematic review was conducted using the method recommended by the Cochrane Collaboration.RESULTS Eleven trials with a total of 743 patients were included in the systematic review. The meta-analysis showed that ω-3 PUFAs were superior to placebo/blank control in the improvement of fatty liver（OR = 2.64, 95%CI： 1.36-5.14; P = 0.004）, plasma biochemical markers of liver function [ALT： 95%CI：-15.77-（-2.91）, P = 0.004; AST： 95%CI：-14.79-（-1.94）, P = 0.01; GGT： 95%CI：-21.33-（-6.92）, P = 0.0001], and plasma biochemical markers of lipid metabolism [TG： 95%CI：-2.38-（-0.21）, P = 0.02; TC： 95%CI：-1.71-（-0.06）, P = 0.04; LDL： 95%CI：-0.53-（-0.23）; P 0.00001].CONCLUSION The current evidence shows that supplementation with ω-3 PUFAs is a practical and effective treatment for NAFLD with regard to improvement of fatty liver, plasma biochemical markers of liver function and lipid metabolism. However, more high-quality, large randomized controlled trials are needed to validate our findings.

关 键 词：Ω-3多不饱和脂肪酸 非酒精性脂肪性肝病 脂肪肝 系统评价 

分 类 号：R575.5[医药卫生—消化系统]