从SMOFlipid®转换为Omegaven®作为肠道衰竭相关肝病的救援疗法
Stella Sabbatini1,2, Fernanda Takamatsu1,3, Christina Belza1,2,3
1Group for Improvement of Intestinal Function and Treatment (GIFT), The Hospital for Sick Children, Toronto, ON, Canada.
Intestinal Failure (New York, N.Y.)
|February 6, 2026
概括
在63.6%的先前接受SMOFlipid®治疗的儿科患者中,Omegaven®逆转了与肠道衰竭相关的晚期肝病 (IFALD). 然而,对于肝功能障碍和门性高血压患者来说,反应的可能性较小.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 肝病学 肝病学是一种肝病学.
- 临床营养学 临床营养学
背景情况:
- 肠道衰竭相关的肝病 (IFALD) 是肠道衰竭的常见并发症,具有有限的治疗途径.
- 欧米茄 (Omegaven®) 是一种被公认的救援疗法,用于治疗内脂类药物 (intralipid®) 患者的IFALD,但其与SMOFlipid®的有效性尚未确立.
研究的目的:
- 评估Omegaven®作为接受SMOFlipid®的儿科患者IFALD的救援疗法.
- 确定Omegaven®在该特定患者群体中逆转晚期IFALD的疗效.
主要方法:
- 一项回顾性研究,涉及患有肠衰竭和晚期IFALD (结合胆红素>50μmol/L2周或更长时间) 的儿童在服用SMOFlipid®时.
- 患者被转换为Omegaven® (1.0 g/kg/d) 治疗至少7周,主要结局是合 bilirubin <34 μmol/L.
主要成果:
- 在11名符合条件的患者中,7人 (63.6%) 在平均12.5周内达到合胆红素的目标水平.
- 没有反应的患者患上胃肠道出血的发病率较高 (75%),INR升高 (1.8),需要持续输血葡萄糖 (75%).
- 在不响应者中,结果包括肝衰竭,多胞体移植或肝肠移植的列表.
结论:
- 转换为Omegaven®有效地逆转了先进的IFALD,超过60%的小儿患者先前接受了SMOFlipid®治疗.
- 诸如合成肝功能障碍和显著的门性高血压等因素可能预测对Omegaven®治疗的反应较差.
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