ω-3脂肪酸对肝切除患者肝功能影响的Meta分析  

Effects of ω-3 fatty acid on liver function in patients undergoing hepatectomy： a Meta-analysis

作　　者：那延立 张城硕[2] 焦奥[2] 李峰 李越 孙宁[2] 张佳林[2] Na Yanli;Zhang Chengshuo;Jiao Ao;Li Feng;Li Yue;Sun Ning;Zhang Jialin(Hepatobiliary Surgery Department and Unit of Organ Transplantation, the First Affiliated Hospital of China Medical University, Shenyang 110001, China)

机构地区：[1]中一东北国际医院普通外一科,沈阳110623 [2]中国医科大学附属第一医院肝胆外科暨器官移植科,沈阳110001

出　　处：《中国医师进修杂志》2018年第7期594-599,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：摘要目的系统评价ω-3脂肪酸对肝切除患者术后肝功能的影响。方法计算机检索PubMed、Embase、Cochrane Library数据库，并辅以手工检索、文献追溯，收集2016年9月以前发表关于ω-3脂肪酸对肝切除患者术后临床疗效影响的随机对照试验（RCT）。采用PRISMA要求进行RCT文献数据提取及质量评价。采用GRADE Profiler系统评价证据质量。采用RevMan 5.3.5软件进行Meta分析。结果根据纳入标准，共入选5篇文献。Meta分析显示，ω-3脂肪酸可以明显降低肝切除患者术后第3天丙氨酸氨基转移酶（ALT）水平[均数差（MD）=-74.89，95% CI-110.02～39.76，P〈0.01]和天冬氨酸氨基转移酶（AST）水平（MD=-60.87，95% CI-96.05～-25.68，P〈0.01），增前白蛋白（Pre-Alb）水平（MD=9.61，95% CI 4.22～15.00，P〈0.01），但未改善术后第3天总胆红素（TBil）水平（MD=-1.13，95% CI-2.48～0.21，P〉0.05）和白蛋白（Alb）水平（MD= 1.16，95% CI-0.35～2.68，P〉0.05）。结论肝切除患者应用ω-3脂肪酸可以明显降低肝切除患者术后第3天ALT和AST水平，升高Pre-Alb水平，但未改善术后第3天TBil和Alb水平。ObjectiveTo study the effects of ω-3 fatty acid on liver function in patients undergoing hepatectomy.MethodsA PubMed, Embase and Cochrane Library database search was performed to retrieve all of the randomized controlled trial （RCT） evaluating the value of perioperative ω-3 fatty acid in patients undergoing hepatectomy until the end of September 2016. Data extraction and quality assessment of RCT were performed in accordance with PRISMA guidelines. The quality of evidence for each postoperative outcome was assessed using the GRAD Profiler system. A random-effects model was used to conduct a Meta-analysis with RevMan 5.3.5 software.ResultsFive documents were identified according to the inclusion criteria. Meta-analysis results showed that ω-3 fatty acid significantly reduced the levels of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） on the third day of the operation in patients undergoing hepatectomy： mean difference （MD）=-74.89 and-60.87, 95% CI-110.02 ？ 39.76 and-96.05？-25.68, P〈0.01; ω-3 fatty acid significantly increased the level of prealbumin （Pre-Alb） on the third day of the operation： MD=9.61, 95% CI 4.22 ？ 15.00, P〈0.01; but ω-3 fatty acid did not improve the levels of total bilirubin （TBil） and albumin （Alb） on the third day of the operation： MD=-1.13 and 1.16, 95% CI-2.48 ？ 0.21 and-0.35 ？ 2.68, P〉0.05.ConclusionsThe ω-3 fatty acid is potentially beneficial in reducing the levels of ALT and AST, and increases the level of Pre-Alb on the third day of the operation in patients undergoing hepatectomy, but does not improve the levels of TBil and Alb.

关 键 词：肝切除术 脂肪酸类 ω3 肝功能试验 META分析 

分 类 号：R657.3[医药卫生—外科学]