自体富血小板胶治疗糖尿病性皮肤溃疡疗效的Meta分析  

Autologous Platelet-rich Gel for the Treatment of Diabetic Skin Ulcers: A Meta-analysis

作　　者：白松杰 颜亚岚 张莉 曾冰 王薇 黄志勇 Bai Songjie;Yan Yalan;Zhang Li(Department of Anesthesiology,Fuwai Hospital Chinese Academy of Medical Sciences,Guangdong 518000,China)

机构地区：[1]中国医学科学院阜外医院深圳医院麻醉科,518000

出　　处：《医学研究杂志》2020年第4期128-134,共7页Journal of Medical Research

基　　金：广东省深圳市科创委知识创新计划基础研究项目(JCYJ20170307161610240)。

摘　　要：目的系统评价自体富血小板胶(APG)治疗糖尿病性皮肤溃疡的有效性及安全性。方法计算机检索PubMed、EMbase、The Cochrane Library、CNKI、WanFang Data和VIP数据库,搜集APG治疗糖尿病性皮肤溃疡的随机对照试验(RCT),检索时限均从建库至2019年8月。由两名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入27个RCT,包括1782例患者。Meta分析结果显示:与对照组比较,APG治疗可增加溃疡愈合率(RR=1.52,95%CI:1.24~1.85,P=0.000)、治疗有效率(RR=1.25,95%CI:1.12~1.40,P=0.000);缩短溃疡愈合时间(MD=-10.61,95%CI:-12.86^-8.36,P=0.000)、住院时间(MD=-13.67,95%CI:-16.07^-11.27,P=0.000);并且不明显增加住院费用(P=0.330)。两组患者不良反应发生率比较,差异无统计学意义(P=0.620)。结论APG治疗糖尿病性皮肤溃疡具有较好的疗效,且无明显不良反应,但上述结论仍需更多高质量的研究予以证明。Objective To systematically review the efficacy and safety of autologous platelet-rich gel(APG)in the treatment of diabetic skin ulcers.Methods PubMed,Embase,The Cochrane Library,CNKI,WanFang Data and VIP databases were systematically searched to collect randomized controlled trials(RCTs)of autologous platelet-rich gel in the treatment of diabetic skin ulcers from inception to August 2019.Two reviews independently screened literature,extracted data and assessed risk of bias of included studies.The meta-analysis was conducted with the Cochrane Collaboration′s RevMan 5.3 software.Results A total of 27 RCTs involving 1782 patients were included.The results of meta-analysis showed that:compared with the control group,the treatment of APG could significantly increase the ulcer healing rate(RR=1.52,95%CI:1.24-1.85,P=0.000),improve the effectiveness rate of treatment(RR=1.25,95%CI:1.12-1.40,P=0.000),shorten the ulcer healing time(MD=-10.61,95%CI:-12.86--8.36,P=0.000)and the length of hospital stay(MD=-13.67,95%CI:-16.07--11.27,P=0.000),and did not increase the hospitalization expenses(P=0.330).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.620).Conclusion APG has a good therapeutic effect on diabetic skin ulcers without obvious adverse reactions.However,the above conclusions need to be verified by more high quality researches.

关 键 词：自体富血小板胶 糖尿病 皮肤溃疡 糖尿病足 META分析 

分 类 号：R4[医药卫生—临床医学]