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目的系统评价ω-3多聚不饱和脂肪酸((ω-3 polyurtsaturated fatty acids,ω-3 PUFAs)对慢性肾脏病(chronic kidney disease,CKD)患者C反应蛋白(C-reactive protein,CRP)的影响。方法检索PubMed、Cochrane library、EMbase数据库,筛选出随机对照试验(randoomialed controlled trial,RCT)文献,检索时间从1960年1月至2015年1月,对文献进行资料提取,应用RevMan 5.2软件进行Meta分析。结果共检索出17篇满足要求的研究。所有研究均为RCT,其中11篇描述了具体的随机化方法,采用了充分的分配隐藏和双向盲法设计;3篇文献未介绍具体随机化方法,采用了单盲设计;3篇文献未提及具体随机化方案和分配隐藏,未采用盲法。纳入的文献均报道了失访和退出情况。共纳入829名患者,平均随访期为(14±9)周(4~48周)。在对CRP的Meta分析中,ω-3PUFAs的使用能降低CKD患者CRP水平,加权化均数差为-0.47,95%CI[-0.90,-0.04],P<0.05。结论ω-3 PUFAs在CKD中对炎症的作用一直存在争议,在本研究中,ω-3 PUFAs能降低透析患者CRP水平。ω-3 PUFAs作为一种营养治疗手段,无明显不良反应,能一定程度的改善CKD患者体内的炎症状态。但对于临床终点事件及长期安全性而言,仍有待大规模、多中心、前瞻性RCT进一步证实。
Objective To evaluate the effects of ω-3 polyurtsaturated fatty acids (ω-3 PUFAs) on C-reactive protein (CRP) in patients with chronic kidney disease (CKD) .Methods PubMed, Cochrane library and EMbase database were searched and the literature of randomized controlled trials (RCT) was screened from January 1960 to January 2015. The data were extracted from the literature and RevMan 5.2 software was used for Meta RESULTS: A total of 17 satisfactory studies were retrieved, all of which were RCTs, of which 11 described specific randomization methods using adequate assignment concealment and two-way blind design, and 3 articles did not describe specific randomization Method, using a single-blind design; 3 articles did not mention specific randomization scheme and distribution of hidden, blind method was not included in the literature were reported lost and withdrawal.A total of 829 patients were enrolled, the average follow-up period was ( 14 ± 9 weeks (range, 4 to 48 weeks.) In the meta-analysis of CRP, the use of ω-3 PUFAs reduced the CRP level in CKD patients with a weighted mean difference of -0.47 and 95% CI [-0.90, -0.04 ], P <0.05.Conclusion Omega-3 PUFAs in CKD The role of inflammation has been controversial, in this study, ω-3 PUFAs can reduce the level of CRP in dialysis patients.ω-3 PUFAs as a nutritional therapy, no significant adverse reactions, can be some degree of improvement in patients with CKD inflammatory status However, a large, multicenter, prospective RCT remains to be confirmed for clinical endpoints and long-term safety.