糖皮质激素治疗肝衰竭疗效和安全性的meta分析  

Effect and safety of glucocorticoids in treatment of hepatic failure:a meta analysis

作　　者：李春雁 何元群 任小丹 郭蒙 谯敏[1] LI Chunyan;HE Yuanqun;REN Xiaodan;GUO Meng;QIAO Min(Department of Gastroenterology,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院消化内科,重庆400016

出　　处：《现代医药卫生》2021年第8期1288-1291,共4页Journal of Modern Medicine & Health

摘　　要：目的采用荟萃分析方法评价糖皮质激素治疗肝衰竭的疗效及安全性。方法使用计算机检索从建库起至2020年8月万方数据知识服务平台、中国知网(CNKI)、维普资讯中文期刊服务平台(VIP)、Web of Science、PubMed、Embase及Cochrane Library数据库发表的相关文献。应用RevMan5.3软件进行meta分析。结果纳入31篇随机对照试验文献。糖皮质激素治疗组患者病死率,以及继发感染和肝性脑病发生率均明显低于对照组,总胆红素、谷丙转氨酶、凝血酶原活动度改善情况均明显优于对照组,差异均有统计学意义(P<0.05);2组患者清蛋白改善情况,以及消化道出血和肝肾综合征发生率比较,差异均无统计学意义(P>0.05)。结论使用糖皮质激素治疗肝衰竭可降低肝衰竭患者病死率,改善相应实验室指标,且未增加发生并发症的风险。Objective To evaluate the effect and safety of glucocorticoids in the treatment of hepatic failure by adopting the meta analysis method.Methods The related literatures published in the databases of Wanfang Data Knowledge Service Platform,CNKI,Weipu Information Chinese periodical service platform,Web of Science,PubMed,Embase and Cochrane Library from their database establishement to August 2020 were retrieved by computer.The data were analyzed by using the RevMan5.3 software.Results Thirty-one articles of randomized controlled trials were included.The mortality rate and incidence rate of secondary infection and hepatic encephalopathy in the glucocorticoids treatment group were significantly lower than those in the control group,and the improvement situation of TBIL,ALT and PTA were better than that of the control group.However the improvement of ALB and the incidence rate of gastrointestinal bleeding and hepatorenal syndrome had no statistical difference between the two groups.Conclusion Using glucocorticoids to treat the hepatic failure can reduce the mortality rate of the patients with hepatic failure,improves the corresponding laboratory indicators,moreover without increasing the risk of complications occurrence.

关 键 词：肝衰竭 糖皮质激素类 治疗结果 安全性 META分析 

分 类 号：R575.3[医药卫生—消化系统] R977.1[医药卫生—内科学]