Stone N J
Northwestern University School of Medicine, 211 E. Chicago Avenue; STE 1050, Chicago, Illinois 60611, USA.
Curr Cardiol Rep. 2000 Sep;2(5):445-51. doi: 10.1007/s11886-000-0059-5.
A recent large-scale, open-label, randomized, controlled trial in 11, 324 myocardial infarction (MI) survivors has shown low-dose fish oil, but not vitamin E, to reduce significantly the cumulative rate of all-cause death, nonfatal MI, and nonfatal stroke. Neither intervention significantly reduced the other primary endpoint, the cumulate rate of cardiovascular death, nonfatal MI, and nonfatal stroke. Analysis of secondary endpoints indicated that the benefits of the 875 mg fish oil capsules containing 850 to 882 mg eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as ethyl esters was in reducing mortality and not in a reduction of nonfatal MI. It was a safe intervention. The internal validity and external validity of the data was examined and the findings placed in clinical perspective. Important questions remain about the benefits of increased plant sources of n-3 polyunsaturated fatty acids (PUFA) for those who cannot obtain or consume fish. Also the benefits of diet versus fish oil supplementation haven't been determined precisely. Although it seems reasonable to increase sources of n-3 PUFA in the diet for those at high risk of coronary heart disease, current data do not support a policy of promoting fish oil capsules for secondary prevention of coronary heart disease.
最近一项针对11324名心肌梗死（MI）幸存者的大规模、开放标签、随机对照试验表明，低剂量鱼油可显著降低全因死亡、非致命性心肌梗死和非致命性中风的累积发生率，但维生素E却无此效果。两种干预措施均未显著降低另一个主要终点，即心血管死亡、非致命性心肌梗死和非致命性中风的累积发生率。对次要终点的分析表明，含有850至882毫克二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）乙酯的875毫克鱼油胶囊的益处在于降低死亡率，而非减少非致命性心肌梗死。这是一种安全的干预措施。研究人员对数据的内部有效性和外部有效性进行了检验，并从临床角度对研究结果进行了分析。对于那些无法获取或食用鱼类的人而言，增加植物来源的n-3多不饱和脂肪酸（PUFA）的益处仍存在重要疑问。此外，饮食与补充鱼油的益处尚未得到确切判定。尽管对于冠心病高危人群而言，增加饮食中n-3 PUFA的来源似乎是合理的，但目前的数据并不支持推广使用鱼油胶囊用于冠心病二级预防的政策。
