左西孟旦对严重脓毒症/脓毒性休克患者病死率影响的Meta分析  

Effect of levosimendan on the overall mortality in patients with severe sepsis or septic shock:a meta-analysis

作　　者：周小洋 许兆军[1] 刘鹏[1] 张玉楚[1] 杨群[1] 胡旭军 陈培服[1] 

机构地区：[1]宁波市第二医院重症医学科,浙江宁波315000

出　　处：《中华危重症医学杂志（电子版）》2017年第4期252-257,共6页Chinese Journal of Critical Care Medicine:Electronic Edition

基　　金：宁波市自然科学基金项目(2016A610139)

摘　　要：目的系统评价左西孟旦对严重脓毒症或脓毒性休克患者病死率的影响。方法计算机检索PubMed、OVID、Cochrane临床试验数据库、万方数据库、中国知网数据库、维普网及中国生物医学文献数据库自建库至2016年12月期间关于左西孟旦治疗(实验组)与传统治疗(对照组)对成人严重脓毒症或脓毒性休克患者病死率影响的随机对照试验。由2名研究者按照纳入及排除标准独立进行文献筛选、提取和质量评估后,使用Stata/SE 11.0软件合并效应量行Meta分析,并绘制漏斗图检测发表偏倚。结果共纳入10篇符合入选标准的文献,共831例患者。Meta分析显示,与对照组比较,实验组对严重脓毒症或脓毒症休克患者的病死率并无明显下降[OR=0.95,95%CI(0.71,1.27),Z=0.36,P=0.721],漏斗图显示各研究间存在发表偏倚。同时,两组患者住ICU时长比较,差异亦无统计学意义[SMD=-0.24,95%CI(-0.56,0.07),Z=1.51,P=0.131]。结论左西孟旦不能降低严重脓毒症或脓毒性休克患者的病死率。Objective To assess the effect of levosimendan on the overall mortality in patients with severe sepsis or septic shock. Methods Randomized controlled trials focused on the effects of levosimendan treatment （experiment group） and traditional treatment （control group） on the overall mortality in adult patients with severe sepsis or septic shock were systematically retrieved from PubMed, OVID, Coehrane Library, Wanfang data, CNKI, VIP net and Chinese Biomedical Database from database inception to December 2016. Two reviewers independently screened articles according to the inclusion and exclusion criteria, extracted the data and evaluated the quality of the included studies. The mate-analysis was performed by Stata/SE 11.0 software, funnel plots were drawn to detect the publication bias. Results A total of 831 patients in 10 studies were included. Meta-analysis indicated that the overall mortality in the experiment group showed no significant difference as compared to the control group [OR = 0.95, 95%CI（0.71, 1.27）, Z= 0.36, P= 0.721], the funnel plots demonstrated publication bias. Meanwhile, there was also no significant difference in the duration of intensive care unit stay between the two groups [SMD =-0.24, 95%CI （-0.56,0.07）, Z= 1.51, P=O.131]. Conclusion Levosimendan can＇t improve the overall mortality in patients with severe sepsis or septic shock.

关 键 词：左西孟旦 脓毒症 休克 脓毒性 病死率 META分析 

分 类 号：R459.7[医药卫生—急诊医学]