氨基酸肠外营养支持对肝硬化患者营养和预后影响的meta分析  

Effect of amino acid-containing parenteral nutrition on the nutrition and prognosis in patients with liver cirrhosis:a meta-analysis

作　　者：陆素芳[1] 丁玉珍[1] 王丹丹[1] 黄睿[1] 赵红利 张晓燕 刘金春[2,3] LU Su-fang;DING Yu-zhen;WANG Dan-dan;HUANG Rui;ZHAO Hong-li;ZHANG Xiao-yan;LIU Jin-chun(Department of Infectious Disease,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008;Department of Pharmacy,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008;Nanjing Medical Center for Clinical Pharmacy,Nanjing 210008)

机构地区：[1]南京大学医学院附属鼓楼医院感染性疾病科,南京210008 [2]南京大学医学院附属鼓楼医院药学部,南京210008 [3]南京临床药学中心,南京210008

出　　处：《中南药学》2022年第11期2665-2671,共7页Central South Pharmacy

基　　金：南京大学医院管理研究所课题项目;南京鼓楼医院医学发展医疗救助基金会资助项目(No.NDYG2020052,No.NDYG2021016);国家自然科学基金青年基金项目(No.81702011)。

摘　　要：目的 通过对肝硬化患者使用氨基酸的肠外营养方式进行meta分析,探索其对肝硬化患者各项肝功能指标的影响。方法 检索中国知网、中国生物医学文献数据库、万方数据库、PubMed和Embase中采用氨基酸作为肝硬化患者肠外营养添加剂的随机对照试验(RCT),检索时间设置为建库至2021年5月31日。对筛选的文献进行数据提取和meta分析,软件使用STATA 15.1,质量评估软件使用Review Manager 5.3。结果 共纳入16篇RCT,meta分析结果显示,与使用常规肠外营养的对照组相比,添加氨基酸的肠外营养的试验组总胆红素(SMD =-0.27,95%CI:-0.43~-0.11)显著降低,白蛋白(SMD=0.67,95%CI:0.03~1.30)显著增加,而谷丙转氨酶(SMD=-0.12,95%CI:-0.27~0.02)和谷草转氨酶(SMD=-0.15,95%CI:-0.35~0.04)改变差异无统计学意义。结论 氨基酸作为肠外营养补充剂可有效改善肝硬化患者的营养状况和肝功能。Objective To determine the effect of amino acid-containing parenteral nutrition on the liver function indexes in patients with liver cirrhosis by meta-analysis.Methods We searched CNKI,China Biology Medicine Disc,Wanfang Database,PubMed and Embase for randomized controlled trials using amino acids as parenteral nutrition additives for patients with liver cirrhosis up to May 31,2021.We conducted meta-analysis of the selected articles and collected data.STATA 15.1 was used in the meta-analysis and Review Manager 5.3 was used for the quality evaluation.Results Totally 16 articles were included.The meta-analysis showed that compared with the control group (using conventional parenteral nutrition),the total bilirubin (SMD=-0.27,95%CI:-0.43~-0.11) in the experimental group (using amino acid added parenteral nutrition) was decreased,while the albumin (SMD=0.67,95%CI:0.03~1.30) was increased.However,there were no statistical differences in alanine aminotransferase (SMD=-0.12,95%CI:-0.27~0.02) and aspartate aminotransferase (SMD= -0.15,95%CI:-0.35~0.04).Conclusion Amino acids as parenteral nutritional supplements can effectively improve the nutrition status and liver function in patients with liver cirrhosis.

关 键 词：氨基酸 肠外营养 肝硬化 营养 预后meta分析 

分 类 号：R969.3[医药卫生—药理学]