接受含鱼油脂肪乳早产儿的结局：一项观察性研究。
Outcomes in preterm infants who received a lipid emulsion with fish oil: An observational study.
机构信息
Department of Pediatrics, Children's Discovery and Innovation Institute, UCLA Mattel Children's Hospital, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
出版信息
JPEN J Parenter Enteral Nutr. 2023 Mar;47(3):354-363. doi: 10.1002/jpen.2464. Epub 2023 Jan 7.
BACKGROUND
100% soybean oil emulsions (SO100) are associated with poor docosahexaenoic acid (DHA) and arachidonic acid (ARA) status in extremely low birth weight (ELBW) infants. A multi-oil emulsion with 15% fish oil (FO15) contains more DHA and ARA than SO100. This study compares clinical outcomes, namely growth and fatty acids, in ELBW infants who received S0100 or FO15.
METHODS
This observational study included ELBW infants born between 2014 and 2019 who received SO100 or FO15 for >7 days. Gas chromatography/mass spectrometry was used to measure erythrocyte fatty acids.
RESULTS
The mean ± SD gestational age was 27 ± 3 and 26 ± 2 weeks for SO100 (n = 43) and FO15 (n = 43), respectively (P = 0.2). DHA (-0.3 ± 0.10% per week, P = 0.026, for FO15 vs -0.2 ± 0.05% per week, P < 0.001, for SO100) and ARA (-0.8 ± 0.21% per week for FO15 vs -0.9 ± 0.17% per week for SO100; P < 0.001 for both) declined in both groups with no difference between groups (P interaction > 0.7 for both). After controlling for days to reach full feeds, the mean difference in weight z score trajectories was similar (Est = -0.08; 95% CI, -0.82 to 0.04; P = 0.2), and SO100 was associated with a nonsignificant increased odds for cholestasis (odds ratio, 3.1; 95% CI, 0.96-10.2; P = 0.059). There was no difference in other clinical comorbidities.
CONCLUSIONS
In comparison with ELBW infants who received SO100, infants who received FO15 still demonstrated a decline in DHA and ARA. Growth and other clinical outcomes were unchanged.
背景
100%大豆油乳剂（SO100）会导致极低出生体重儿（ELBW）体内二十二碳六烯酸（DHA）和花生四烯酸（ARA）水平较差。含有 15%鱼油的多油乳剂（FO15）中 DHA 和 ARA 的含量高于 SO100。本研究比较了 ELBW 婴儿在接受 SO100 或 FO15 治疗后，其临床结局（包括生长和脂肪酸）的差异。
方法
本观察性研究纳入了 2014 年至 2019 年间出生的 ELBW 婴儿，这些婴儿接受 SO100 或 FO15 治疗超过 7 天。气相色谱/质谱法用于测量红细胞脂肪酸。
结果
SO100 组（n=43）和 FO15 组（n=43）的平均（±SD）胎龄分别为 27±3 周和 26±2 周（P=0.2）。与 SO100 组相比，FO15 组 DHA（每周下降 0.3±0.10%，P=0.026；每周下降 0.2±0.05%，P<0.001）和 ARA（每周下降 0.8±0.21%，P<0.001；每周下降 0.9±0.17%，P<0.001）均呈下降趋势，且两组间无差异（P交互值均>0.7）。在控制达到全肠喂养天数后，两组体重 z 评分轨迹的平均差异相似（估计值=-0.08；95%CI，-0.82 至 0.04；P=0.2），且 SO100 与胆汁淤积的发生几率增加无关（比值比，3.1；95%CI，0.96-10.2；P=0.059）。其他临床并发症在两组间无差异。
结论
与接受 SO100 的 ELBW 婴儿相比，接受 FO15 的婴儿体内 DHA 和 ARA 仍呈下降趋势。生长和其他临床结局无变化。
Zotero 插件