持续静滴奥美拉唑治疗上消化道出血疗效的Meta-分析  

Clinical effectiveness of continuous infusion of omeprazole in treatment of upper gastrointestinal bleeding: a Meta-analysis

作　　者：方宝霞 方东菲 陈富超 李锐[2] FANG Baoxia;FANG Dongfei;CHEN Fuchao;LI Rui(Department of Pharmacy, Dongfeng Hospital, Hubei University of Medicine, Shiyan 442008, China;Department of Pharmacy, Zhongxiang people's hospital, Zhongxiang 431900, China)

机构地区：[1]湖北医药学院附属东风医院药学部,湖北十堰442008 [2]湖北省钟祥市人民医院药学部,湖北钟祥431900

出　　处：《药物评价研究》2018年第11期2102-2107,共6页Drug Evaluation Research

基　　金：湖北省卫生计生科研基金项目(WJ2015MB290);十堰市科学技术研究与开发计划项目(16Y60)

摘　　要：目的评价持续静脉滴注奥美拉唑治疗上消化道出血的疗效及安全性。方法检索PubMed、EMbase、Cochrane系统评价数据库(CDSR)、中国学术期刊全文数据库(CNKI)和维普中文科技期刊数据库(VIP)数据库,检索时限2000年1月-2017年12月。收集持续静脉滴注奥美拉唑与间歇静脉滴注奥美拉唑治疗上消化道出血的随机对照试验(RCT)文献,采用Rev Man 5.2软件进行Meta分析。结果纳入16篇RCT,共2 683例患者进行Meta分析。结果显示:持续静脉滴注奥美拉唑与对照组(间歇静脉滴注奥美拉唑)比较,持续静脉滴注组的显效率[OR=2.24,95%CI(1.67~3.00),Z=5.43],总有效率[OR=2.42,95%CI(1.61~3.62),Z=4.28],平均输血量[MD=-0.80,95%CI(-1.01^-0.59),Z=7.33],差异均有统计学意义(P<0.01);再出血率[OR=0.56,95%CI(0.29~1.07),Z=1.75],差异无统计学意义。结论持续静脉滴注奥美拉唑治疗上消化道出血的疗效优于间歇静脉滴注,但受纳入文献质量的影响,以上结论需要高质量的临床证据进一步证实。Objective To evaluate the clinical efficacy and safety of continuous intravenous infusion of omeprazole in patients with upper gastrointestinal bleeding. Methods Databases including PubMed, Embase, Cochrane Database of Systematic Reviews(CDSR), CNKI, and VIP were searched to collect randomized controlled trials(RCTs) about continuous intravenous versus intermittent intravenous infusion of omeprazole in the treatment of upper gastrointestinal hemorrhage from January 2000 to December 2017. Meta-analysis was conducted by RevMan 5.2 software. Results A total of 2 683 patients involved in 16 RCTs were searched. Meta-analysis showed that according to cure rates [OR=2.24, 95%CI(1.67—3.00), Z=5.43, P<0.01], the total effective rates [OR=2.42, 95%CI(1.61—3.62), Z=4.28, P<0.01], and the average transfusion volume [MD=-0.80, 95%CI(-1.01—-0.59), Z=7.33, P<0.01] in the continuous intravenous infusion group, significant differences were noted between the continuous intravenous infusion of omeprazole group and the control group(intermittent intravenous infusion of omeprazole). There was no statistical significance between the two groups in the rebleeding rates [OR=0.56, 95%CI(0.29—1.07), Z=1.75, P=0.08]. Conclusion The current domestic evidence suggests that the clinical effect continuous intravenous infusion of omeprazole is better than that of control group. However, because of the low quality of the included trials, the above conclusion needs to be further confirmed based on high-quality evidence in clinic.

关 键 词：奥美拉唑 持续静脉滴注 上消化道出血 质子泵抑制剂 META-分析 

分 类 号：R969[医药卫生—药理学]