熊去氧胆酸治疗早产儿胃肠外营养相关性胆汁淤积的Meta分析  

Solicitousness Acid in Treatment of Preterm Infants with Parenthetical Nutrition-Associated Cholera:A Meta-Analysis

作　　者：周丽[1] 徐晓红[1] 易彬[2] 蒋成鹏[1] 陈灏予 王宝林[1] 

机构地区：[1]甘肃省妇幼保健院消化感染科,兰州730050 [2]甘肃省妇幼保健院新生儿科,兰州730050

出　　处：《医学综述》2017年第15期3107-3113,共7页Medical Recapitulate

摘　　要：目的系统评价熊去氧胆酸治疗早产儿胃肠外营养相关性胆汁淤积(PNAC)的疗效。方法计算机检索Pub Med、EMBASE、Cochrane图书馆、中国生物医学文献数据库、万方和中国知网,时间和语种不限,检索时间从建库截止至2016年7月;纳入基于熊去氧胆酸对比常规治疗(营养液+护肝+防感染)方案治疗PNAC的随机对照试验,由2名研究者独立提取数据,并根据Cochrane Handbook 5.1偏倚风险评估工具评价纳入研究质量,数据分析采用Rev Man 5.0软件。结果共纳入4项研究,包含168例患者,Meta分析结果提示:与常规治疗相比,熊去氧胆酸治疗早产儿PNAC可以有效降低总胆红素(MD=-44.97,95%CI-51.13^-38.81,P<0.000 01)、直接胆红素(MD=-16.01,95%CI-18.09^-13.92,P<0.000 01)、丙氨酸转氨酶(MD=-15.98,95%CI-19.68^-12.28,P<0.000 01)、总胆汁酸(MD=-49.19,95%CI-55.07^-43.31,P<0.000 01)和α-谷氨酰转肽酶(MD=-23.13,95%CI-29.56^-16.70,P<0.000 01),然而在改善患者有效率差异无统计学意义(OR=4.14,95%CI 0.71~24.04,P=0.14)。结论基于熊去氧胆酸方案可以作为早产儿PNAC有效的治疗方案之一,然而基于纳入研究质量较低,样本量较小,本结论的临床实践尚需谨慎。Objective To assess the efficacy of solicitousness acid （UDCA） in treatment of preterm infants with par- enthetical nutrition-associated cholera （PNAC）. Methods PubMed, EMBASE, the Cochrane library, CBM, Wan fang, and CNKI were searched from inception to July 2016, to include randomized controlled trials of UDCA versus conventional treatment （CT） for PNAC. Two reviewers extracted data independently, and assessed the methodological quality according to CochraneHandbook 5.1. Data analysis was conducted using RevMan 5.0. Results Four studies were included, and involved 168 patients. The results of Meta-analysis showed that compared with CT, UDCA could significantly reduce the level of TBIL（MD = - 44.97,95% CI - 51. 13- - 38.81, P 〈 0. 000 01 ）, DBIL （ MD = - 16.01,95% CI - 18.09- - 13.92, P 〈 0.000 01）, ALT（MD = - 15.98,95% CI - 19.68- - 12.28,P 〈0. 000 01 ） ,TBA（MD = -49.19, 95% CI -55.07- -43.31 ,P 〈0.000 01 ） and GGT（MD = - 23.13,95% CI - 29.56- - 16.70, P 〈 0. 000 01 ）. However,there were no statistical significant differences in improvement of overall response rate（ OR = 4.14,95% CI 0. 71-24. 04 ,P = 0. 14）. Conclusion Limited evidence indicated that UDCA was one of the effective regimens in the treatment of PNAC.

关 键 词：肠外营养相关性胆汁淤积 熊去氧胆酸 早产儿 META分析 

分 类 号：R575[医药卫生—消化系统]