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机构地区:[1]新疆生产建设兵团医院(石河子大学医学院第二附属医院)肝病科 [2]新疆生产建设兵团医院(石河子大学医学院第二附属医院)超声科 [3]新疆五家渠市第二人民医院内科,新疆维吾尔自治区昌吉州831300 [4]上海交通大学医学院附属瑞金医院感染科,上海市200025
出 处:《世界华人消化杂志》2015年第27期4411-4417,共7页World Chinese Journal of Digestology
基 金:2013年度新疆生产建设兵团科技计划基金资助项目;No.2013AB028 ;2014年新疆生产建设兵团医院院级课题基金资助项目;No.LC2014012~~
摘 要:目的:评价奥曲肽治疗肝硬化合并顽固性腹水的有效性.方法:通过计算机检索Pub Med、EMBASE、中国生物医学文献数据库(C h i n e s e Bio Medical Literature Database,CBM)、中国期刊全文数据库(China National Knowledge Infrastructure,CNKI)、中文科技期刊全文数据库(VIP)和万方数据库发表的有关奥曲肽治疗肝硬化合并顽固性腹水的临床研究,最终纳入奥曲肽治疗肝硬化合并顽固性腹水的随机对照试验(randomized control trials,RCT).采用Jadad质量记分法对纳入研究进行严格的方法学质量评价,Meta分析采用Rev Man5.2软件进行.结果:共纳入符合标准的RCT 9篇,样本量为696例.Meta分析结果显示:与常规治疗组相比,奥曲肽能明显提高肝硬化合并顽固性腹水治疗的有效率(OR=3.18,95%C I:2.03-4.97,P<0.00001);同时,患者体质量(MD=-8.75,95%CI:-11.25--6.25,P<0.00001)、腹水量(SMD=-31.8,95%CI:-35.23--28.37,P<0.00001)、腹围(S M D=-8.75,95%CI:-11.55--5.95,P<0.00001)、24h尿量(SMD=8.18,95%CI:3.69-12.67,P=0.0004)及血清尿素氮(M D=-1.18,95%C I:-2.31--0.06,P=0.04)等指标均有明显改善,但在改善门静脉主干内径以及血清肌酐方面无明显优势.结论:在常规病因治疗、限制水钠摄入,白蛋白、利尿剂、预防感染及保肝药物治疗的基础上,奥曲肽能显著提高肝硬化合并顽固性腹水患者治疗的有效率,降低患者体质量,腹水量,缩小患者腹围,明显改善患者24 h尿量以及血清尿素氮,具有较为理想的治疗效果.AIM:To evaluate the efficacy and safety of octreotide in the treatment of cirrhosis with refractory ascites.METHODS:PubMed,EMBASE,CBM,CNKI,VIP and Wanfang Database were searched to retrieved studies evaluating the efficacy of octreotide in the treatment of cirrhosis with refractory ascites.All the related data that met our standards were extracted.The quality of the included trials was evaluated according to the Jadad score.RevMan 5.2 software was used for meta-analysis.RESULTS:A total of 9 randomized controlled trials involving 696 patients were included.The results of meta-analysis showed that the octreotide group was superior to the control group in treatment efficiency(OR=3.18,95%CI:2.03-4.97,P〈0.00001),weight reduction(MD=-8.75,95%CI:-11.25--6.25,P〈0.00001),ascites reduction(SMD=-31.8,95%CI:-35.23--28.37,P〈0.00001),decreased abdominal girth(SMD=-8.75,95%CI:-11.55--5.95,P〈0.00001),increased blood urea nitrogen(BUN)(MD=-1.18,95%CI:-2.31--0.06,P=0.04) and 24 h urine volume(SMD=8.18,95%CI:3.69-12.67,P=0.0004),but there was no statistical difference in serum creatinine(sCr) or portal vein trunk diameter(PVD).CONCLUSION:Current evidence suggests that octreotide could improve treatment efficiency in terms of weight reduction,ascites reduction,decreased abdominal girth,increased BUN and 24 h urine volume.
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