de Meijer Vincent E, Gura Kathleen M, Meisel Jonathan A, Le Hau D, Puder Mark
Vascular Biology Program, Department of Surgery, Children's Hospital Boston, Harvard Medical School, 300 Longwood Ave, Fegan 3, Boston, MA 02115, USA.
Arch Surg. 2010 Jun;145(6):547-51. doi: 10.1001/archsurg.2010.80.
To update knowledge on the management of parenteral nutrition-associated liver disease (PNALD) and to review the clinical data on the use of parenteral fish oil for reversal of PNALD.
A literature review was conducted by searching the MEDLINE database (May 1, 2009) using the keywords parenteral nutrition-associated liver disease, fish oil, omega-3, Omegaven, and lipid emulsion.
All articles reporting clinical cases with the use of parenteral fish oil for management of PNALD.
Three reviewers independently analyzed the epidemiological, clinical, and treatment data of the articles.
Six case reports (10 patients) and 2 cohort studies (12 and 18 patients) were analyzed.
Fish oil-derived emulsions have been demonstrated to reverse preexisting PNALD and to prevent and treat essential fatty acid deficiency. Its ability to prevent PNALD is currently under investigation. Although the mechanism has yet to be fully understood, the advantages of fish oil-based lipid emulsions over soybean oil-based lipid emulsions seen to date suggest that fish oil-based emulsions would be better suited for use in long-term parenteral nutrition.
更新有关肠外营养相关肝病（PNALD）管理的知识，并回顾使用肠外鱼油逆转PNALD的临床数据。
通过使用关键词“肠外营养相关肝病”“鱼油”“ω-3”“Omegaven”和“脂质乳剂”检索MEDLINE数据库（2009年5月1日）进行文献综述。
所有报道使用肠外鱼油管理PNALD的临床病例的文章。
三名审阅者独立分析文章的流行病学、临床和治疗数据。
分析了6篇病例报告（10例患者）和2项队列研究（12例和18例患者）。
鱼油来源的乳剂已被证明可逆转已有的PNALD，并预防和治疗必需脂肪酸缺乏。其预防PNALD的能力目前正在研究中。尽管其机制尚未完全了解，但迄今为止，基于鱼油的脂质乳剂相对于基于大豆油的脂质乳剂的优势表明，基于鱼油的乳剂更适合用于长期肠外营养。
