聚乙二醇与乳果糖治疗肝性脑病患者疗效和安全性的Meta分析  

Efficacy and safety of polyethylene glycol and lactulose in the treatment of patients with hepatic encephalopathy:a Meta-analysis

作　　者：曾娇 郭贵海[1] Zeng Jiao;Guo Guihai(Department of Gastroenterology,First Affiliated Hospital,Nanchang University,Nanchang 330000,Jiangxi Province,China)

机构地区：[1]南昌大学第一附属医院消化内科,南昌市330000

出　　处：《实用肝脏病杂志》2021年第1期99-102,共4页Journal of Practical Hepatology

摘　　要：目的比较聚乙二醇(PEG)与乳果糖治疗肝性脑病(HE)患者的疗效和安全性。方法利用计算机在PubMed、EMbase、Cochrane、万方数据库、中国知网中检索自建库至2019年11月20日期间关于PEG与乳果糖治疗HE患者的随机对照试验,选取符合纳入条件的文献并对其进行质量评价。应用RevMan 5.3软件进行Meta分析。结果纳入8项随机对照研究,包括PEG处理组249例和乳果糖处理组244例患者。Meta分析结果显示,PEG组不良反应发生率为12.9%,显著低于乳果糖组的27.4%(P<0.0001);PEG组24 h HESA评分改善率为91.5%,显著高于乳果糖组的65.5%(P<0.0001);PEG组和乳果糖组住院日分别为[(5.4±3.7)d和(7.7±6.9)d,P<0.0001],治疗前后血氨分别下降了[(59.5±53.5)μmol/L和(42.4±44.2)μmol/L,P=0.13]。结论PEG较乳果糖治疗HE患者不良反应少,能更快地降低患者24 h HESA评分,缩短住院日,其临床应用值得进一步观察。Objective The aim of this study was to meta-analyzed the randomized controlled trials(RCTs)of polyethylene glycol(PEG)and lactulose in the treatment of patients with hepatic encephalopathy(HE).Methods The meta-analysis was conducted in PubMed,EMbase,Cochrane,WanFang Data and CNKI by computer search and retrieve untill November 20,2019.RCTs were selected and their quality was evaluated by RevMan 5.3 software.Results A total of 8 randomized controlled studies were obtained,including 249 patients in the PEG group and 244 patients in the lactulose group;the results of Meta analysis showed that the incidence of adverse reactions in PEG group was 12.9%,significantly lower than that in lactulose group(27.4%,P<0.0001);the improvement rate of 24-hour HESA score in PEG group was 91.5%,significantil higher than 65.5%in lactulose group(P<0.0001);the hospital stay in PEG group and lactulose group was[(5.4±3.7)d and(7.7±6.9)d,P<0.0001],and serum ammonia decreased after treatment were[(59.5±53.5)μmol/L and(42.4±44.2)μmol/L,P=0.13]in the two groups.Conclution Compared with lactulose intervention,the administration of PEG has fewer adverse reactions in patients with HE,which might decrease 24-hour HESA score,shorten hospital stay,and needs further investigation.

关 键 词：肝性脑病 聚乙二醇 乳果糖 META分析 治疗 

分 类 号：R575.3[医药卫生—消化系统]