Moyes Lisa H, Hamid Rizwana, Clutton Juliet, Oien Karin A, McKee Ruth F, Forrest Ewan H
University Department of Surgery, Glasgow Royal Infirmary, Glasgow, UK.
Department of Gastroenterology, Royal Alexandra Hospital, Glasgow, UK.
Frontline Gastroenterol. 2012 Apr;3(2):94-97. doi: 10.1136/flgastro-2011-100056. Epub 2012 Mar 13.
Parenteral nutrition-associated cholestasis (PNAC) is a severe complication of parenteral nutrition. Standard feed preparations contain soybean and olive oil that are rich in ω-6 polyunsaturated fats, and which studies suggest can be hepatotoxic. Preparations containing fish oil, rich in ω-3 polyunsaturated fats, may be hepatoprotective and have been used in the critical care setting as immunotherapy. A case demonstrating dramatic improvement in liver function and overall clinical condition in an adult with PNAC and intestinal failure within 8 weeks of changing to a fish oil-based parenteral feed is reported. As far as is known, this is the first report of an adult patient whose parenteral nutrition-associated liver disease resolved after a parenteral nutrition lipid emulsion was changed to the fish oil-containing emulsion, SMOFlipid.
肠外营养相关胆汁淤积（PNAC）是肠外营养的一种严重并发症。标准的肠外营养制剂含有富含ω-6多不饱和脂肪的大豆油和橄榄油，研究表明这些油可能具有肝毒性。含有富含ω-3多不饱和脂肪的鱼油的制剂可能具有肝脏保护作用，并已在重症监护环境中用作免疫疗法。本文报告了一例成年PNAC和肠衰竭患者，在改用基于鱼油的肠外营养制剂后8周内，肝功能和整体临床状况显著改善。据了解，这是首例成年患者在将肠外营养脂质乳剂更换为含鱼油的乳剂SMOFlipid后，其肠外营养相关肝病得到缓解的报告。
