鱼油预防心血管疾病的系统评价_《中国循证医学杂志》

作者：

 唐文娟 ¹ , 唐海沁 ¹ , 杨琳琳 ¹ , 王夏芹 ¹ , 孙业桓 ² , 黄晓晖 ³

1. 安徽医科大学第一附属医院老年心血管科（合肥 230022）；2. 安徽医科大学公共卫生学院（合肥 230022）；3. 安徽医科大学药学院（合肥 230022）;

关键词：

n-3 多不饱和脂肪酸鱼油心血管疾病 Meta 分析

DOI：

10.7507/1672-2531.20090216

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价鱼油（n-3 多不饱和脂肪酸）防治心血管疾病的效果。
方法　计算机检索PubMed、Cochrane 图书馆临床对照试验资料库（2009 年第1 期）、CBM、CNKI、万方等数据库，同时筛检了纳入文献的参考文献，按纳入与排除标准纳入鱼油在心血管疾病防治方面的随机对照试验。由两名评价员独立评价文献质量、提取资料并交叉核对，如遇分歧讨论解决。而后采用RevMan 4.2 软件对资料进行Meta 分析。
结果　共纳入5 项研究，包括37 689 例研究对象。Meta 分析结果显示：① 与安慰剂组比较，鱼油可降低心血管性死亡事件［RR=0.91，95%CI（0.84，0.98）］、总心血管事件［RR=0.95，95%CI（0.91，0.98）］、心肌梗死［RR=0.79，95%CI（0.65，0.96）］和心绞痛［RR=0.79，95%CI（0.64，0.96）］的发生率；② 在降低心血管疾病住院率、全因死亡事件、猝死及心衰发生率方面，与安慰剂比较差异无统计学意义（P gt;0.05）；③ 在心律失常［RR=1.14，95%CI（0.80，1.62）］和卒中发生率［RR=1.12，95%CI（0.97，1.30）］方面，与安慰剂比较有轻度升高，但差异均无统计学意义（P gt;0.05）。
结论　鱼油能降低总心血管事件、总心血管性死亡、心肌梗死及心绞痛的发生率。在全因死亡事件、猝死、心衰及心血管疾病住院事件方面疗效不明显，而在心律失常及卒中方面发生率有轻度升高但无统计学意义。结果表明鱼油在高危人群中防治心血管疾病可获益。

引用本文： 唐文娟,唐海沁,杨琳琳,王夏芹,孙业桓,黄晓晖. 鱼油预防心血管疾病的系统评价. 中国循证医学杂志, 2009, 09(11): 1200-1206. doi: 10.7507/1672-2531.20090216 复制

1.	Wang C, Harris WS, Chung M, et al. n-3 Fatty acids from fish or fish oil supplement, but not α-linolenicacid, benefitcardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr, 2006, 84(1): 5-17.
2.	Landmrk K, Aim CS. Alpha-linolenic acid, cardiovascular disease and sudden death. Tidsskr Nor Laegeforen, 2006, 126(21): 2792-2794.
3.	Metcalf RG, Sanders P, James MJ, et al. Effect of dietary n-3 polyunsaturated fatty acids on the inducibility of ventricular tachy. Am J Cardiol, 2008, 101(6): 758-761.
4.	Hooper L, Thompson RL, Harrison RA, et al. Risks and benefits of omega 3 for mortality, cardiovascular disease and cancer, systematic review. BMJ, 2006, 332(7554): 752-760.
5.	Yokoyama M, Origasa H, Matsuzaki M, et al . Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet, 2007, 369(9567): 1090-1098.
6.	GISSI-HF Investigators, Tavazzi L, Maggioni AP, et al. Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial. Lancet, 2008, 372(9645): 1223-1230.
7.	Merritt H, William E, Cynthia M, et al. Trial implantable defibrillators: a randomized controlled tachycardia and ventricular fibrillation in patients with fish oil supplementation and risk of ventricular. JAMA, 2005, 293(23): 2884-2891.
8.	Ingeborg A, Peter L, John C, et al. Effect of fish oil on ventricular tachyarrhythmia and ventricular arrhythmia (sofa) randomized trial defibrillators: the study on omega-3 fatty acids and death in patients with implantable cardioverter. JAMA, 2006, 295(22): 2613-2619.
9.	Roberto M, Federica B, Elena B, et al. Early Protection Against Sudden Death by n-3 Polyunsaturated Fatty Acids After Myocardial Infarction Time-Course Analysis of the Results of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI)-Prevenzione. Circulation, 2002, 105(4): 1897-1903.
10.	Harris WS. Fish oils and plasma lipid and lipoprotein metabolism in humans: a critical review. J Lipid Res, 1989, 30(6): 785-807.
11.	Hornstra G. Influence of dietary fish oil an arterial thrombosis and atherosclerosis in animal models and in man. J Intern Med Suppl, 1989, 731: 53-59.
12.	Weiner BH. Ockene IS, et al. Inhibition of atherosclerosis by codliver oil in a hyperlipidemic swine model. N Eng J Med, 1986, 315: 841-846.
13.	Dehmer GJ, Popma JJ, et al. Reduction in the rate of early restenosis after coronary angioplasty by a diet supplemented with n-3 fatty acids. N Eng J Med, 1988, 319: 733-740.
14.	Mclennan PL, Abevwardena MY, Charnock JS. Dietary fish oil prevents ventricular fibrillation following coronary artery occlusion and reperfusion. Am Heart J, 1988, 116(3): 709-717.
15.	王建中, 朱瑞龙, 邱仁芳, 等. 鱼油多不饱和脂肪酸对人血小板、红细胞必需脂肪酸组成以及过氧化-抗氧化能力的影响. 中国医药工业杂志, 1992, 23(2): 74-77.
16.	刘萍, 边强. 鱼油的药效作用研究, 国外医药—合成药生化药制剂分册, 2001, 22(6): 353-354.

1. Wang C, Harris WS, Chung M, et al. n-3 Fatty acids from fish or fish oil supplement, but not α-linolenicacid, benefitcardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr, 2006, 84(1): 5-17.
2. Landmrk K, Aim CS. Alpha-linolenic acid, cardiovascular disease and sudden death. Tidsskr Nor Laegeforen, 2006, 126(21): 2792-2794.
3. Metcalf RG, Sanders P, James MJ, et al. Effect of dietary n-3 polyunsaturated fatty acids on the inducibility of ventricular tachy. Am J Cardiol, 2008, 101(6): 758-761.
4. Hooper L, Thompson RL, Harrison RA, et al. Risks and benefits of omega 3 for mortality, cardiovascular disease and cancer, systematic review. BMJ, 2006, 332(7554): 752-760.
5. Yokoyama M, Origasa H, Matsuzaki M, et al . Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet, 2007, 369(9567): 1090-1098.
6. GISSI-HF Investigators, Tavazzi L, Maggioni AP, et al. Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial. Lancet, 2008, 372(9645): 1223-1230.
7. Merritt H, William E, Cynthia M, et al. Trial implantable defibrillators: a randomized controlled tachycardia and ventricular fibrillation in patients with fish oil supplementation and risk of ventricular. JAMA, 2005, 293(23): 2884-2891.
8. Ingeborg A, Peter L, John C, et al. Effect of fish oil on ventricular tachyarrhythmia and ventricular arrhythmia (sofa) randomized trial defibrillators: the study on omega-3 fatty acids and death in patients with implantable cardioverter. JAMA, 2006, 295(22): 2613-2619.
9. Roberto M, Federica B, Elena B, et al. Early Protection Against Sudden Death by n-3 Polyunsaturated Fatty Acids After Myocardial Infarction Time-Course Analysis of the Results of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI)-Prevenzione. Circulation, 2002, 105(4): 1897-1903.
10. Harris WS. Fish oils and plasma lipid and lipoprotein metabolism in humans: a critical review. J Lipid Res, 1989, 30(6): 785-807.
11. Hornstra G. Influence of dietary fish oil an arterial thrombosis and atherosclerosis in animal models and in man. J Intern Med Suppl, 1989, 731: 53-59.
12. Weiner BH. Ockene IS, et al. Inhibition of atherosclerosis by codliver oil in a hyperlipidemic swine model. N Eng J Med, 1986, 315: 841-846.
13. Dehmer GJ, Popma JJ, et al. Reduction in the rate of early restenosis after coronary angioplasty by a diet supplemented with n-3 fatty acids. N Eng J Med, 1988, 319: 733-740.
14. Mclennan PL, Abevwardena MY, Charnock JS. Dietary fish oil prevents ventricular fibrillation following coronary artery occlusion and reperfusion. Am Heart J, 1988, 116(3): 709-717.
15. 王建中, 朱瑞龙, 邱仁芳, 等. 鱼油多不饱和脂肪酸对人血小板、红细胞必需脂肪酸组成以及过氧化-抗氧化能力的影响. 中国医药工业杂志, 1992, 23(2): 74-77.
16. 刘萍, 边强. 鱼油的药效作用研究, 国外医药—合成药生化药制剂分册, 2001, 22(6): 353-354.

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《中国循证医学杂志》

鱼油预防心血管疾病的系统评价

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《中国循证医学杂志》

鱼油预防心血管疾病的系统评价

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