非选择性β受体阻滞剂对肝硬化腹水患者病死率影响的Meta分析  

The effect of non-selectiveβ-blockers on mortality in patients with cirrhosis and ascites:a Meta-analysis

作　　者：艾明华[1] 谭小平[1] 朱艳艳 徐超[1] 张庆[1] 徐灵 李杰 AI Minghua;TAN Xiaoping;ZHU Yanyan;XU Chao;ZHANG Qing;XU Ling;LI Jie(Department of Gastroenterology,No.1 Hospital Affiliated to Yangtze University,Jingzhou 434000;Department of Urology,Jingzhou Third People’s Hospital;Department of Blood Transfusion,No.1 Hospital Affiliated to Yangtze University,China)

机构地区：[1]长江大学附属第一医院消化内科,湖北荆州434000 [2]荆州市第三人民医院泌尿外科 [3]长江大学附属第一医院输血科

出　　处：《胃肠病学和肝病学杂志》2020年第11期1287-1290,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的评估非选择性β受体阻滞剂(non-selectiveβ-blockers,NSBB)对肝硬化腹水患者病死率的影响。方法检索有关NSBB对肝硬化腹水影响的研究。主要结果是肝硬化患者的病死率及难治性腹水的病死率。采用Newcastle-Ottawa量表评估方法评估各研究证据的质量。结果共纳入8项观察性研究,包括3627例肝硬化腹水患者,1630例使用NSBB治疗(NSBB组),1997例未使用NSBB治疗(非NSBB组)。NSBB组患者病死率为38.6%,而非NSBB组患者病死率为42.2%(OR=0.87,95%CI:0.56~1.35,I 2=80%;P=0.54)。NSBB组的难治性腹水患者病死率为33.3%,而非NSBB组的难治性腹水患者病死率为32.1%(OR=1.11,95%CI:0.57~2.15,I 2=83%;P=0.77)。3项研究符合高质量和5项符合中等质量。结论接受NSBB治疗的肝硬化腹水患者病死率未见增加。但鉴于大多数研究证据的质量不高,需要高质量的前瞻性研究。Objective To evaluate the effect of non-selectiveβ-blockers(NSBB)on mortality in patients with cirrhosis and ascites.Methods Literatures about the effect of NSBB on cirrhosis and ascites were searched.The main outcome was mortality in patients with cirrhosis and refractory ascites.Newcastle-Ottawa scale assessment method was used to evaluate the quality of evidence in each study.Results A total of 8 observational studies were included,and 3627 patients with cirrhosis and ascites were included in the study,including 1630 treated with NSBB(NSBB group)and 1997 unused NSBB(non-NSBB group).The mortality rate was 38.6%in the NSBB group and 42.2%in the non-NSBB group(OR=0.87,95%CI:0.56-1.35,I 2=80%;P=0.54).The mortality rate of patients with refractory ascites using was 33.3%in the NSBB group,while the mortality rate of patients with refractory ascites was 32.1%in the non-NSBB group(OR=1.11,95%CI:0.57-2.15,I 2=83%;P=0.77).3 studies met high quality and 5 met intermediate quality.Conclusion There is no increase in mortality in patients with cirrhosis and ascites receiving NSBB.However,given the low quality of most research evidence,high-quality prospective studies are needed.

关 键 词：腹水 非选择性Β受体阻滞剂 肝硬化 病死率 

分 类 号：R575.2[医药卫生—消化系统]