肠外营养鱼油脂肪乳剂预防早产儿视网膜病的Meta分析  

Meta-analysis on the prevention of retinopathy of prematurity by fish oil fat emulsion in parenteral nutrition

作　　者：袁静[1] 朱雪萍[1] Yuan ring;Zhu Xue-ping(Department of Neonatology,Children＇s Hospital of Soochow University,Sozhou 215000,China)

机构地区：[1]苏州大学附属儿童医院新生儿科,215025

出　　处：《中国斜视与小儿眼科杂志》2018年第3期25-30,共6页Chinese Journal of Strabismus & Pediatric Ophthalmology

基　　金：国家自然基金面上项目(81771626);江苏省妇幼健康重点人才项目(FRC201731);苏州市科技发展计划项目(SS201428);苏州市重点病种诊疗技术项目(LCZX201612);民生科技一关键技术应用研究项目(SS201644)

摘　　要：目的通过Meta分析和整合肠外营养鱼油脂肪乳剂对早产儿视网膜病变(retinopathy of prematurity,ROP)的影响。方法通过计算机检索PUBMED、EMBASE、MEDLINE、中国生物医学文献数据库、维普、万方和中国知网,收集从1990年1月1日至2018年3月20日国内外公开发表的胃肠外营养鱼油脂肪乳剂与ROP的有关文献。采用卡方检验评估异质性,采用Revman5.3进行统计分析。结果共纳入选7项研究,其中4项为随机对照试验,3项为观察性研究,共1086名早产儿。Meta分析结果显示,鱼油脂肪乳剂可减少ROP需要接受激光治疗(RR=0.47,95%CI:0.24～0.90)和重度ROP的发病率(RR=0.51,95%CI:0.31～0.84);观察组胆汁淤积发生率(RR=0.31,95%CI:0.15～0.68)较对照组(RR=0.19,95%CI:0.05～0.69)降低。结论肠外营养鱼油脂肪乳剂可有效减少早产儿ROP需要接受激光治疗和重度ROP的发病率,也可降低胆汁淤积的发病率。Objective To systematically review and integrate the outcome of fish-oil lipid emulsions in the prevention on retinopathy of prematurity through Mata analysis. Methods The 4 randomized controlled trials（ RCTs） and 3 observational studies ranging from 1990 to march 2018 published at home and abroad on parenteral fish-oil lipid emulsions and retinopathy of prematurity were collected from PUBMED, EMBASE, MEDLINE, Chinese biomedical database, VIP, Wan Fang and CNKI through computer. The quality of trials were evaluated by the Cochrane Handbook 5. 1 bias risk assessment tool system and the Revman 5. 3 software. Results Seven literatures containing a total of 1086 infants were included. Meta analysis results showed that fish-oil lipid emulsions decreased the rate about laser treatments or worsening of ROP,（ RR =0.47, 95%CI ： 0.24～0.90）,（RR = 0.51, 95%CI ： 0.31～0.84）.The amount of patients with cholestasis in the observation group was less than the control group（ RR = 0. 31,95% CI ： 0. 15 ～0. 68）,（ RR = 0. 19,95% CI ： 0. 05 ～0. 69）. Conclusion Parenteral fish-oil lipid emulsions can effectively reduce the risk of progression of ROP and ROP deterioration in premature infants. The incidence of cholestasis is also reduced due to the use of fish-oil fat emulsions.

关 键 词：视网膜病 鱼油 早产儿 全胃肠外营养 META分析 

分 类 号：R774.1[医药卫生—眼科]