血必净联合乌司他丁治疗脓毒血症的meta分析  

Clinical effectiveness of Xuebijing combined with ulinastation for treating sepsis:a Meta-analysis

作　　者：隋明亮 顾蓓茜 张国新[1] 徐云峰[1] 刘会平[1] 

机构地区：[1]上海交通大学医学院附属苏州九龙医院重症医学科,江苏苏州215028

出　　处：《吉林医学》2017年第4期664-669,共6页Jilin Medical Journal

摘　　要：目的:系统评价血必净联合乌司他丁治疗脓毒症患者的临床疗效。方法:计算机检索Pub Med、Cochrane library、中国生物医学文献数据库、中国知网、万方数字化期刊全文数据库和维普数据库,查找有关血必净联合乌司他丁治疗脓毒症患者临床疗效的随机对照试验,由两名评价者独立选择实验、提取资料和评估方法学质量,采用stata 12.0软件进行Meta分析。结果:共纳入16项随机对照实验研究,共计1 209例受试者(试验组615例,对照组594例)。Meta分析结果提示:与单用乌司他丁或血必净或仅使用常规方案治疗脓毒症患者相比,血必净联合乌司他丁能够明显降低患者28天及7d后的病死率[RR=0.64,95%CI(0.43,0.95),P=0.026;RR=0.46,95%CI(0.32,0.66),P<0.01],降低患者7d的急性生理功能和慢性健康状况评分(APACHEⅡ)[WMD=-4.92,95%CI(-6.55,-3.3),P<0.01],缩短机械通气时间[WMD=-3.11,95%CI(-3.96,-2.26),P<0.01],以及平均ICU住院时间[WMD=-3.41,95%CI(-4.22,-2.61),P<0.01]。结论:血必净联合乌司他丁联用优于单用血必净、乌司他丁及常规治疗方案,但仍需长期随访的大样本随机对照试验予以评价。Objective To evaluate the clinical effectiveness of Xuebijing combined with ulinastation for treating sepsis.Method The database such as Pub Med,Cochrane library,CBM,CNKI,Wan Fang Database and VIP database were searched to collect randomized controlled trials（ RCTs）.Studies were screened,data were extracted,and the methodological quality was assessed by two reviewers independently.Meta-analysis was carried out with Stata 12.0 software.Results A total of 16 studies involving 1 209 participants（ experimental group 615 cases,control group 594 cases） were enrolled for Meta-analysis according to the inclusion and exclusion criteria.The results showed that compared with the group of routine therapies and group of single administration of either Ulinastatin or Xuebijing,experimental group of Xuebijing combined with Ulinastatin was superior in the following aspects with significant differences： morality：[RR = 0.64,95% CI（ 0.43,0.95）,P = 0.026; RR = 0.46,95% CI（0.32,0.66）,P〈0.01],7 d APACHEⅡ：[WMD =-4.92,95 % CI（-6.55,-3.3）,P〈0.01];duration of mechanical ventilation：[WMD =-3.11,95 % CI（-3.96,-2.26）,P〈0.01],the average length of ICU stay：[WMD =-3.41,95 %CI（-4.22,-2.61）,P〈0.01].Conclusion This analysis Suggests that Xuebijing combined with ulinastatin for treating sepsisis superior to both the routine therapies and the single administration of either Ulinastatin or Xuebijing.It provides a new and prospective therapeutic method for sepsis.However,this conclusion has to be further verified by large scale randomized controlled trials.

关 键 词：血必净 乌司他丁 脓毒症 META分析 

分 类 号：R459.7[医药卫生—急诊医学]