Evidence-Based Medicine Center of Lanzhou University, The First Clinical Medical School of Lanzhou University, Lanzhou, China.
Nutr Rev. 2013 Dec;71(12):815-21. doi: 10.1111/nure.12053. Epub 2013 Nov 1.
To assess the comparative safety and efficacy of a new parenteral lipid emulsion containing soybean oil, medium-chain triglycerides, olive oil, and fish oil (SMOFlipid20%) for postoperative patients, a meta-analysis of randomized controlled trials (RCTs) was conducted. Six RCTs with a total of 306 patients were included in the analysis. The overall quality of evidence for each outcome was evaluated using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) software. Compared with a soybean-based (Lipoven20%) and a soybean- and olive oil-based (ClinOleic20%) lipid emulsion, SMOFlipid20% was associated with lower levels of hepatic enzymes, suggesting less toxicity. Changes in low-density lipoprotein triglyceride and C-reactive protein levels were also lower with SMOFlipid20% compared with Lipoven20%. Differences between SMOFlipid20% and a lipid emulsion containing medium- and long-chain triglycerides (MCT/LCT20%) were not statistically significant. For all trials, there were no significant differences in adverse events and length of hospital stay. The quality of evidence from the RCTs evaluating SMOF20% versus Lipoven20% was moderate, while most of the evidence from RCTs of SMOF20% versus ClinOleic20% and MCT/LCT20% lipid emulsions was low.
为了评估含有大豆油、中链甘油三酯、橄榄油和鱼油的新型肠外脂质乳剂（SMOFlipid20%）在术后患者中的相对安全性和疗效，我们对随机对照试验（RCT）进行了荟萃分析。纳入的分析共包含 6 项 RCT 和 306 名患者。使用 Grading of Recommendations, Assessment, Development, and Evaluation（GRADE）软件评估了每个结局的证据整体质量。与基于大豆的（Lipoven20%）和基于大豆和橄榄油的（ClinOleic20%）脂质乳剂相比，SMOFlipid20%与较低的肝酶水平相关，提示毒性较小。与 Lipoven20%相比，SMOFlipid20%也能降低 LDL 甘油三酯和 C 反应蛋白水平的变化。SMOFlipid20%与含有中长链甘油三酯（MCT/LCT20%）的脂质乳剂之间的差异没有统计学意义。对于所有试验，不良事件和住院时间均无显著差异。评估 SMOF20%与 Lipoven20%的 RCT 提供的证据质量为中等，而评估 SMOF20%与 ClinOleic20%和 MCT/LCT20%脂质乳剂的 RCT 提供的大部分证据质量为低。
