非诺贝特辅助治疗原发性胆汁性肝硬化效果的Meta分析  

Efficacy of adjuvant therapy with fenofibrate for primary biliary cirrhosis: a Meta-analysis

作　　者：俞媛[1] 杨宗国[1] 陈姼姼[1] 陆云飞[1] 徐庆年[1] 陈晓蓉[1] 

机构地区：[1]复旦大学附属公共卫生临床中心,上海200540

出　　处：《临床肝胆病杂志》2015年第10期1630-1633,共4页Journal of Clinical Hepatology

基　　金：上海申康医院发展中心医药验方项目(SHDC2012411)

摘　　要：目的对非诺贝特辅助治疗原发性胆汁性肝硬化(PBC)患者的有效性进行系统评估。方法检索中国知网、万方、中国生物医学文献数据库、Pubmed、Embase及Cochrane library数据库中自建库至2014年12月31日间发表的相关随机对照试验(RCT),对纳入的文献进行资料提取和质量评价,采用Stata10.1软件对数据进行统计分析。若具有同质性则选择固定效应模型分析,有异质性则选择随机效应模型分析。结果共纳入6篇RCT进行分析。结果显示:辅助使用非诺贝特治疗后,PBC患者的GGT、ALT、ALP水平较治疗前明显下降(标准化均数差分别为-1.595、-0.447、-2.124,P值均<0.05);而AST、TBil水平在干预前后差异无统计学意义(P值均>0.05)。在改善免疫球蛋白M方面,非诺贝特辅助治疗前后差异无统计学意义(P>0.05)。结论基于当前证据,非诺贝特辅助治疗PBC可以有效改善患者肝功能,但是并不能有效改善患者的免疫功能。本文样本量较少,尚需要更多大样本、多中心、高质量的RCT进行验证。Objective To assess the efficacy of adjuvant therapy with fenofibrate for primary biliary cirrhosis（ PBC）. Methods CNKI,Wanfang Data,China Biology Medicine,Pub Med,Embase,and Cochrane library were searched for the pertinent literature of randomized controlled trials（ RCTs） of adjuvant therapy with fenofibrate for PBC published up to December 31,2014. Data extraction and quality assessment were carried out,and the data were statistically analyzed by Stata10. 1 software. Respectively,for heterogeneity test. The fixed effect model is chosen for homogeneity,and the random effect model is chosen for heterogeneity. Results Six RCTs met the inclusion criteria. Treatment with fenofibrate was associated with significantly reduced levels of gamma- glutamyl transpeptidase,alanine aminotransferase,and alkaline phosphatase in PBC patients（ SMD =- 1. 595,- 0. 447,and- 2. 125,respectively,all P〈0. 05）. There were no significant changes in the levels of aspartate aminotransferase and total bilirubin after adjuvant therapy with fenofibrate（ both P〈0. 05）. Also,fenofibrate led to no significant improvement in immunoglobulin M（ P〈0. 05）. Conclusion Fenofibrate,which improves the indicators of liver function but leads to no changes in immunological indicators,appears to be an effective adjuvant therapy in PBC patients. There is a critical need for more large-scale,multi- center,high- quality RCTs to determine its effect on liver disease- related morbidity and mortality.

关 键 词：肝硬化 胆汁性 普鲁脂芬 META分析 

分 类 号：R575.22[医药卫生—消化系统]