多不饱和脂肪酸对透析患者炎症标志物的疗效：随机临床试验的系统评价和网络荟萃分析。
Efficacy of Polyunsaturated Fatty Acids on Inflammatory Markers in Patients Undergoing Dialysis: A Systematic Review with Network Meta-Analysis of Randomized Clinical Trials.
机构信息
School of Medicine, College of Medicine, Taipei Medical University, Taipei 11042, Taiwan.
Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 11042, Taiwan.
出版信息
Int J Mol Sci. 2019 Jul 25;20(15):3645. doi: 10.3390/ijms20153645.
The effects of polyunsaturated fatty acids (PUFAs) on inflammatory markers among patients receiving dialysis have been discussed for a long time, but previous syntheses made controversial conclusion because of highly conceptual heterogeneity in their synthesis. Thus, to further understanding of this topic, we comprehensively gathered relevant randomized clinical trials (RCTs) before April 2019, and two authors independently extracted data of C-reactive protein (CRP), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) for conducting network meta-analysis. Eighteen eligible RCTs with 962 patients undergoing dialysis were included in our study. The result showed that with placebo as the reference, PUFAs was the only treatment showing significantly lower CRP (weighted mean difference (WMD): -0.37, 95% confidence interval (CI): -0.07 to -0.68), but the CRP in PUFAs group was not significantly lower than vitamin E, PUFAs plus vitamin E, or medium-chain triglyceride. Although no significant changes were noted for hs-CRP and IL-6 levels, PUFAs showed the best ranking among treatments according to surface under the cumulative ranking. Therefore, PUFAs could be a protective option for patients receiving dialysis in clinical practice.
多不饱和脂肪酸（PUFAs）对接受透析治疗的患者的炎症标志物的影响已经讨论了很长时间，但是由于之前的综合分析存在高度概念上的异质性，因此得出了有争议的结论。因此，为了进一步了解这个问题，我们在 2019 年 4 月之前全面收集了相关的随机临床试验（RCT），并由两位作者独立提取 C 反应蛋白（CRP）、高敏 C 反应蛋白（hs-CRP）和白细胞介素 6（IL-6）的数据进行网络荟萃分析。我们的研究共纳入了 18 项符合条件的 RCT，涉及 962 名接受透析治疗的患者。结果表明，与安慰剂相比，PUFAs 是唯一显示 CRP 显著降低的治疗方法（加权均数差（WMD）：-0.37，95%置信区间（CI）：-0.07 至-0.68），但 PUFAs 组的 CRP 水平并不明显低于维生素 E、PUFAs 加维生素 E 或中链甘油三酯。虽然 hs-CRP 和 IL-6 水平没有显著变化，但根据累积排序曲线下面积（SUCRA），PUFAs 在治疗方法中排名最高。因此，在临床实践中，PUFAs 可能是透析患者的一种保护选择。
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