门冬氨酸鸟氨酸治疗脂肪肝疗效Meta分析  

Meta analysis of efficacy of ornithine aspartate in the treatment of patients with fatty liver

作　　者：张志华[1] 顾天翊 陈柳莹[1] 陆伦根[1] Zhang Zhihua;Gu Tianyi;Chen Liuying(Department of Gastroenterology,Jiaotong University School of Medicine,Shanghai 200080,China)

机构地区：[1]上海交通大学附属第一人民医院消化科,上海市200080

出　　处：《实用肝脏病杂志》2018年第2期233-236,共4页Journal of Practical Hepatology

摘　　要：目的评价门冬氨酸鸟氨酸治疗脂肪肝患者的疗效。方法检索中国知网(CNKI)、万方、维普、PubMed、EMBASE、Medline和Cochrane library自建库至2017年7月20日发表的门冬氨酸鸟氨酸治疗脂肪肝患者的临床随机对照试验,应用Cochrane手册进行风险偏倚评价,采用Jadad 7分量表进行文献质量评分。应用RevMan5.3进行Meta分析。结果纳入符合要求的9篇中文文献,共计727例脂肪肝患者。Meta分析结果显示,门冬氨酸鸟氨酸治疗脂肪肝患者临床总有效率显著高于常规对照组【OR=3.71,95%CI(1.85,7.46),P=0.0002】;降低总胆固醇合并效应值MD=-3.04,95%CI-3(.76,-2.31),P<0.0000,降低甘油三酯(TG)合并效应值MD=-1.60,95%CI(-2.55,-0.65),P=0.0009;降低血清ALT合并效应值MD=-34.04,95%CI(-61.73,-6.35),P=0.02;降低AST合并效应值MD=-9.48,95%CI(-24.66,5.70),P=0.22;相比异甘草酸镁治疗,门冬氨酸鸟氨酸治疗脂肪肝患者的临床总有效率显著升高【OR=4.06,95%CI(1.91,8.65),P=0.0003】。结论门冬氨酸鸟氨酸治疗脂肪肝患者具有较好的治疗效果,可以改善肝功能指标,降低血脂水平。门冬氨酸鸟氨酸治疗脂肪肝患者的疗效尚需更多设计良好的临床试验证实。Objective To evaluate the efficacy of ornithine aspartate in the treatment of patients with fatty liver.Methods According to the inclusion and exclusion criteria,China National Knowledge Infrastructure(CNKI),Wanfang database,PubMed,EMBASE and Cochrane library up to July 20,2017 were screened for randomized controlled trial of ornithine aspartate in the treatment of patients with fatty liver.The Cochrane handbook was used to assess the risk bias,and the Jadad 7 subscales was used to document the quality score.Meta analysis by using RevMan 5.3 was made.Results A total of 727 Chinese patients with fatty liver were enrolled in the 9 Chinese clinical trials.The results of Meta analysis showed that total clinical efficiency rate in L-ornithine-L-aspartate treatment was much higher as compared to that in the control[OR=3.71,95%CI(1.85,7.46),P=0.0002];the decreased serum total cholesterol level was[MD=-3.04,95%CI(-3.76,-2.31),P<0.00001],and the decreased serum triglyceride level was[MD=-1.60,95%CI(-2.55,-0.65),P=0.0009];the total effective rate in L-ornithine-L-aspartate treatment was[OR=11.99,95%CI(2.36,60.91),P=0.003];the decreased serum ALT was[MD=-34.04,95%CI(-61.73,-6.35),P=0.02],and the decreased serum AST level was[MD=-9.48,95%CI(-24.66,5.70),P=0.22];the decrease total serum bilirubin was[MD=-14.92,95%CI(-20.70,-9.15),P<0.00001].Conclusion The application of L-ornithine-L-aspartate in the treatment of patients with fatty liver has a better therapeutic effect,which might improve the indexes of liver function and blood lipids.The efficacy of Lornithine L-aspartate in the treatment of patients with fatty liver needs to be confirmed by multi-center,welldesigned randomized clinical trials in the future.

关 键 词：脂肪肝 门冬氨酸鸟氨酸 疗效 META分析 

分 类 号：R575.5[医药卫生—消化系统]