果糖类注射剂对血糖影响的循证医学评价  

Effect of fructose injection on blood glucose:an evidence-based medicine evaluation

作　　者：张俊芳[1] 文睿[1] 廖广仁[1] 袁雪琴[2] 

机构地区：[1]广东省人民医院广东省医学科学院药学部,广州510080 [2]广东药学院,广州510006

出　　处：《实用药物与临床》2013年第8期705-710,共6页Practical Pharmacy and Clinical Remedies

摘　　要：目的评价果糖类注射剂对血糖的影响及其安全性。方法检索EMBase、维普资讯数据库、中国生物医学光盘数据库、中国期刊全文数据库、万方数据库、Cochrane系统评价和临床试验数据库,收集2004-2011年有关果糖类制剂对血糖影响的随机对照试验,分为非糖尿病组和糖尿病组,对纳入研究分别进行质量评价和Meta分析。结果共纳入13个中文随机对照试验,共1 093例患者;均无明显的ADR,基础条件差异无统计学意义(P>0.05);其中8个为非糖尿病试验(813例),5项研究为糖尿病试验(280例)。各组间均不存在异质性,采用固定效应模型进行Meta分析。其中6项研究为果糖对非糖尿病患者血糖的影响,MD=-2.05(95%CI:-2.47,-1.62),差异有统计学意义(P<0.01)。2项研究转化糖对非糖尿病患者血糖的影响MD=-0.78(95%CI:-1.22,-0.33),两组比较差异有统计学意义(P<0.05)。果糖对糖尿病患者的影响MD=0.51(95%CI:0.26,0.77),差异有统计学意义(P<0.01)。倒漏斗图分析结果提示可能存在发表偏倚。筛选出果糖对非糖尿病患者血糖影响的研究进行敏感性分析,结果与之前结论一致。结论果糖类注射剂对非糖尿病患者的血糖影响明显小于葡萄糖;对糖尿病患者的血糖影响与生理盐水对比差异无统计学意义。Objective To evaluate the effects and safety of fructose injection on blood glucose.Methods Data of randomized controlled trials on effects and safety of fructose on blood glucose between 2004-2011 were retrieved from EMBase,VIP information database,CBM,China Journal Full-text Database,Wanfang Database,Cochrane systematic Evaluation and Clinical Trial database.Subjects in the retrieved literature were divided into non-diabetic group and diabetic group.Meta-analysis and quality evaluation on selected trials were carried out.Results 13 randomized controlled trials were selected in the study with 1 093 subjects.Of all trials,8 were on non-diabetic subjects（n =813）and 5on diabetic patients （n =280）.No significant difference in fundamental condition and no apparent ADR was found among all these subjects.No significant neterogeneity was found in all groups,fixed effect model was used for Meta analysis.There were significant differences in 6 trials which investigate the effects of fructose injection on blood glucose of on non-diabetic subjects with MD ＝2.05（95％ CI：-2.47,-1.62） （P ＜0.01）,and 2 trials of effects of invertose injection on blood glucose of non-diabetic subjects with MD =-0.78 （95％ CI：-1.22,-0.33） （P ＜ 0.05）.There were also significant differences in trials on effects of fructose injection on blood glucose of diabetic patients with MD =0.51 （95 ％ C1：0.26,0.77） （P ＜ 0.01）.Funnel plot analysis showed that it may exist publiantion bias.Results were found after sensitivity analysis in screened trials on effects of fructose injection on blood glucose in non-diabetic subjects.Conclusion The effect of fructose on blood glucose of non-diabetic subjects is smaller than that of glucose,for diabetic patients,there is no significant difference between fructose and normal saline treatment.

关 键 词：果糖 血糖 循证医学 评价 

分 类 号：R587.1[医药卫生—内分泌]