Department of Neonatology, Jagiellonian University Medical College, Kraków, Kopernika, Poland.
Pediatrics. 2011 Feb;127(2):223-8. doi: 10.1542/peds.2010-2427. Epub 2011 Jan 3.
The retina contains rods and cones that have membranes highly enriched with docosahexaenoic acid (DHA). Infants born prematurely are at risk of DHA insufficiency, because they may not have benefited from a full third trimester of the mother's lipid stores. Moreover, within the first 2 to 3 weeks of life, the main sources of lipids for premature infants are fat emulsions, which do not contain DHA.
This observational study was designed to compare the safety and efficacy outcomes of an intravenous fat emulsion that consists of fish-oil emulsion (contains DHA) with soybean and olive oil, administered from the first day of life to 40 infants who weighed <1250 g; results were obtained from a historical cohort of 44 preterm neonates who were given an emulsion of soybean and olive oil. The primary study outcomes were the occurrence of retinopathy and need for laser therapy and cholestasis. Infants in the 2 groups were comparable with regard to demographic and clinical characteristics and were subjected to the same conventional therapy.
There was a significantly lower risk of laser therapy for infants who received an emulsion of soybean, olive oil, and fish oil (P = .023). No significant differences were found in acuity and latency of visual evoked potentials between infants in the 2 groups. There was no infant with cholestasis among those who received fish-oil emulsion, and there were 5 subjects with cholestasis in the historical group (P = .056).
Fish-oil-based fat emulsion administered from the first day of life may be effective in the prophylaxis of severe retinopathy.
视网膜含有富含二十二碳六烯酸（DHA）的棒状和锥状细胞。早产儿有 DHA 不足的风险，因为他们可能没有从母亲的脂质储备的第三个完整孕期中受益。此外，在生命的前 2 到 3 周内，早产儿的主要脂质来源是脂肪乳剂，其不含有 DHA。
本观察性研究旨在比较从出生第一天开始至 40 名体重<1250g 的婴儿中给予含有鱼油乳剂（含有 DHA）的大豆和橄榄油的静脉内脂肪乳剂的安全性和疗效结果；结果来自于接受大豆和橄榄油乳剂的 44 名早产儿的历史队列。主要研究结果是视网膜病变和激光治疗的发生以及胆汁淤积的发生。两组婴儿在人口统计学和临床特征方面具有可比性，并且接受了相同的常规治疗。
接受大豆、橄榄油和鱼油乳剂的婴儿接受激光治疗的风险显著降低（P=0.023）。两组婴儿的视力诱发电位的视力和潜伏期无显著差异。接受鱼油乳剂的婴儿中没有胆汁淤积的病例，而历史组中有 5 例胆汁淤积（P=0.056）。
从出生第一天开始给予的基于鱼油的脂肪乳剂可能对预防严重的视网膜病变有效。
