미숙아의 정맥영양제 투여에 의한 간기능 부작용 발생에 있어서 Fish Oil 함유 대 Soybean Oil 함유 지방유제의 영향비교

초록

Objective : Parenteral nutrition (PN) is critical for growth and therapeutic effect in premature infants. However, long term PN is associated with development of PN associated liver disease (PNALD). Since the omega-6 fatty acid in soybean oil fat emulsion could be responsible for promoting PNALD, fish oil fat emulsion has been used to reduce this adverse effect. This study aimed to evaluate the efficacy of fish oil fat emulsion in reduction of PNALD. Methods : This study was designed for premature infants who were administered PN with fat emulsion for at least 4 weeks, at the Seoul St. Mary’s hospital neonatal intensive care unit. Between September 2013 and February 2014, preterm infants who received PN with soybean oil fat emulsion were classified as the SO group. From September 2014 to August 2015, preterm infants who received PN with fish oil fat emulsion were classified as the FO group. The change of aspartate transaminase (AST), alanine transaminase (ALT) and direct bilirubin (DB), weight, total protein, albumin and triglyceride (TG) were investigated on the first day and the last day of PN administration. Results : The level of AST decreased by 0.5 IU/L in the FO group, and increased 8.5 IU/L in the SO group (P=0.02). The ALT and DB increased to 13 IU/L and 0.18 mg/dL respectively, in the FO group, and 27.5 IU/L and 0.53 mg/dL respectively, in the SO group (P=0.051, 0.247). No significant difference was observed in weight and total protein. However, the change of albumin levels in the FO group was significantly greater than in the SO group (P=0.01). Also, TG levels decreased by/to 90 mg/dL in the FO group and increased by/to 4.5 mg/dL in the SO group (P=0.03). Conclusion : This study suggests that fish oil fat emulsion lowers the risk of PNALD. Subsequently, fish oil fat emulsion was effective in the improvement of nutritional status in preterm infants.

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