前列地尔治疗乙型肝炎疗效的Meta分析  

Meta Analysis on the Treatment of Hepatitis B with Aprostadil Injection

作　　者：孙宇[1] 赵庆春[1] 樊蓉[1] 史国兵[1] 任天舒[1] 党大胜[1] Sun Yu Zhao Qingchun Fan Rong Shi Guobing Ren Tianshu Dang Dasheng(The General Hospital of Shenyang Military, Shenyang 110840, China)

机构地区：[1]沈阳军区总医院,沈阳110840

出　　处：《中国药事》2017年第1期53-59,共7页Chinese Pharmaceutical Affairs

摘　　要：目的:综合评价前列地尔治疗乙型肝炎的疗效。方法:收集有关前列地尔治疗乙型肝炎的随机或半随机对照研究,根据纳入和排除标准纳入文献并进行质量评价,进行Meta分析并对结果作敏感性分析和亚组分析。结果:纳入17篇文献均属于低质量文献。Meta分析结果提示前列地尔治疗乙型肝炎的临床总有效率[比值比(OR)=3.19,95%CI(2.48,4.09)],前列地尔对总胆红素(TBil)的改善情况[MD=-48.56,95%CI(-66.73,-30.39)],前列地尔对谷丙转氨酶(ALT)的改善情况[MD=-45.08,95%CI(-64.34,-25.82)],前列地尔对凝血酶原活度(PTA)的改善情况[MD=-14.42,95%CI(-18.55,-10.82)],这些结果通过敏感性分析未出现结果逆转。结论:尽管Meta分析提示前列地尔能提高乙型肝炎的临床总有效率并且能改善肝功能和凝血指标,但由于文献的质量较低,影响了结果的准确性,因此,其疗效仍有待高质量的随机对照试验来评价。Objective： To evaluate the effect ofalprostadil on liver failure of hepatitis B. Methods： Randomized or semi-randomized controlled trials on alprostadil for liver failure of hepatitis B were collected and screened according to the criteria of inclusion and exclusion. The quality of each trial was evaluated and then meta analysis was conducted. The results of meta analysis were assessed with the analysis of sensitivity and subgroup. Results： All seventeen included trials had low quality. The result of meta analysis showed that alprostadil could enhance the curative effect of hepatitis B [OR=3.19, 95% CI （2.48, 4.09）] and reduce the total bilirubin [Mean difference=-48.56, 95% CI （-66.73, -30.39）], glutamic-pyruvic transaminase[Mean difference=-45.08, 95% CI（- 64.34, -25.82）], and prothrombin time activity [Mean difference=-14.42, 95% CI （-18.55, -10.82）]. These results were not reversed in the analysis of sensitivity. Conclusion： Although the results of meta analysis showed that alprostadil could enhance the curative effect of hepatitis B and reduce the index of liver function and coagulation, the accuracy of the result was low due to the poor quality of the included trials. Thus, the effect of alprostadil on liver failure of hepatitis B needs to be further evaluated through randomized controlled trials with high quality.

关 键 词：前列地尔 乙型肝炎 META分析 总胆红素 谷丙转氨酶 凝血酶原活度 

分 类 号：R512.6[医药卫生—内科学]