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欧米伽-3多不饱和脂肪酸预防结直肠癌术后并发症的Meta分析

Omega-3 polyunsaturated fatty acids in the prevention of postoperative complications in colorectal cancer: a meta-analysis.

作者信息

Xie Hai, Chang Yan-Na

机构信息

Department of Emergency, The First Hospital of Lanzhou University.

Department of Anesthesiology, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, People's Republic of China.

出版信息

Onco Targets Ther. 2016 Dec 9;9:7435-7443. doi: 10.2147/OTT.S113575. eCollection 2016.

DOI:10.2147/OTT.S113575
PMID:28003759
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5158178/
Abstract

OBJECTIVE

To evaluate systematically the clinical efficacy of omega-3 polyunsaturated fatty acids (PUFAs) in the prevention of postoperative complications in colorectal cancer (CRC) patients.

MATERIALS AND METHODS

Published articles were identified by using search terms in online databases - PubMed, Embase, and the Cochrane Library - up to March 2016. Only randomized controlled trials investigating the efficacy of omega-3 PUFAs in CRC were selected and analyzed through a meta-analysis. Subgroup, sensitivity, and inverted funnel-plot analyses were also conducted.

RESULTS

Eleven articles with 694 CRC patients were finally included. Compared with control, omega-3 PUFA-enriched enteral or parenteral nutrition during the perioperative period reduced infectious complications (risk ratio [RR] 0.63, 95% confidence interval [CI] 0.47-0.86; =0.004), tumor necrosis factor alpha (standard mean difference [SMD] -0.37, 95% CI -0.66 to -0.07; =0.01), interleukin-6 (SMD -0.36, 95% CI -0.66 to -0.07; =0.02), and hospital stay (MD -2.09, 95% CI -3.71 to -0.48; =0.01). No significant difference was found in total complications, surgical site infection, or CD4:CD8 cell ratio.

CONCLUSION

Short-term omega-3 PUFA administration was associated with reduced postoperative infectious complications, inflammatory cytokines, and hospital stay after CRC surgery. Due to heterogeneity and relatively small sample size, the optimal timing and route of administration deserve further study.

摘要

目的

系统评价ω-3多不饱和脂肪酸（PUFAs）预防结直肠癌（CRC）患者术后并发症的临床疗效。

材料与方法

通过在在线数据库——PubMed、Embase和Cochrane图书馆中使用检索词，检索截至2016年3月发表的文章。仅选择调查ω-3 PUFAs在CRC中疗效的随机对照试验，并通过荟萃分析进行分析。还进行了亚组分析、敏感性分析和倒漏斗图分析。

结果

最终纳入11篇文章，共694例CRC患者。与对照组相比，围手术期给予富含ω-3 PUFA的肠内或肠外营养可降低感染性并发症（风险比[RR] 0.63，95%置信区间[CI] 0.47 - 0.86；P = 0.004）、肿瘤坏死因子α（标准均数差[SMD] -0.37，95% CI -0.66至 -0.07；P = 0.01）、白细胞介素-6（SMD -0.36，95% CI -0.66至 -0.07；P = 0.02）以及缩短住院时间（MD -2.09，95% CI -3.71至 - 0.48；P = 0.01）。在总并发症、手术部位感染或CD4:CD8细胞比值方面未发现显著差异。

结论

CRC手术后短期给予ω-3 PUFAs与降低术后感染性并发症、炎症细胞因子水平及缩短住院时间相关。由于存在异质性且样本量相对较小，最佳给药时机和途径值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/e904f27f62fb/ott-9-7435Fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/d45994145277/ott-9-7435Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/cc2f044f8904/ott-9-7435Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/cb4b4fc7aae0/ott-9-7435Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/9b93415ccfbe/ott-9-7435Fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/f2c936ccc066/ott-9-7435Fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/c224f1d6487e/ott-9-7435Fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/e904f27f62fb/ott-9-7435Fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/d45994145277/ott-9-7435Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/cc2f044f8904/ott-9-7435Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/cb4b4fc7aae0/ott-9-7435Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/9b93415ccfbe/ott-9-7435Fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/f2c936ccc066/ott-9-7435Fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/c224f1d6487e/ott-9-7435Fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a6/5158178/e904f27f62fb/ott-9-7435Fig7.jpg

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