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多组份脂肪乳剂与大豆油脂肪乳剂用于极低出生体重早产儿的比较:一项前后对照研究。

Multi-component lipid emulsion vs soy-based lipid emulsion for very low birth weight preterm neonates: A pre-post comparative study.

机构信息

Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.

Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada.

出版信息

J Perinatol. 2019 Aug;39(8):1118-1124. doi: 10.1038/s41372-019-0425-7. Epub 2019 Jun 24.

Abstract

OBJECTIVE

To examine the effectiveness of soybean oil-medium chain triglycerides-olive oil-fish oil lipid emulsion (SMOF-LE) on clinical outcomes of very-low-birth-weight neonates.

STUDY DESIGN

We conducted a pre-post comparative study of very-low-birth-weight neonates, dividing them according to lipid emulsion received: Intralipid (soy-based; n = 680) or SMOF-LE (n = 617). Primary outcomes were mortality, chronic lung disease, severe retinopathy, infection, and necrotising enterocolitis. Secondary outcomes were cholestasis, osteopenia, time to full feeds, and time to regain birthweight.

RESULTS

Baseline characteristics between groups were comparable. Primary outcomes did not differ significantly between groups, although any retinopathy was significantly lower in the SMOF-LE group. SMOF-LE group had lower odds of cholestasis, osteopenia, and lipid interruption, and reduced times to full feeds and to regain birthweight.

CONCLUSIONS

Compared with Intralipid, SMOF-LE was not associated with differences in mortality and major morbidities but was associated with lower odds of any retinopathy, cholestasis, and osteopenia; and improved lipid tolerance.

摘要

目的

研究大豆油-中链甘油三酯-橄榄油-鱼油脂肪乳(SMOF-LE)对极低出生体重儿临床结局的影响。

研究设计

我们对极低出生体重儿进行了一项前后对照研究,根据所接受的脂肪乳剂进行分组:Intralipid(大豆基;n=680)或 SMOF-LE(n=617)。主要结局是死亡率、慢性肺疾病、严重视网膜病变、感染和坏死性小肠结肠炎。次要结局是胆汁淤积、骨质疏松、完全喂养时间和恢复出生体重时间。

结果

两组间的基线特征无显著差异。主要结局在两组间无显著差异,但 SMOF-LE 组任何视网膜病变的发生率显著降低。SMOF-LE 组胆汁淤积、骨质疏松和脂肪中断的发生率较低,完全喂养和恢复出生体重的时间也较短。

结论

与 Intralipid 相比,SMOF-LE 与死亡率和主要并发症无差异相关,但与较低的任何视网膜病变、胆汁淤积和骨质疏松发生率以及改善的脂质耐受性相关。

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