乌司他丁联合血必净注射液治疗脓毒症临床疗效的meta分析  

Meta-analysis of clinical efficacy of ulinastatin combined with xuebijinginjection in the treatment of sepsis

作　　者：周衍香 周超[1] 刘泉[1] 纪莉 朱童 朱莺莺 ZHOU Yanxiang;ZHOU Chao;LIU Quan;JI Li;ZHU Tong;ZHU Yingying(Department of Critical Care Medicine,The Affiliated Taian City Central Hospital of Qingdao University,Tai’an,Shandong 271000,China)

机构地区：[1]青岛大学附属泰安市中心医院重症医学科,山东泰安271000

出　　处：《重庆医学》2023年第S01期133-137,共5页Chongqing medicine

基　　金：山东省临床重点专科建设项目(2020-29);山东省泰安市科技发展计划项目(2018NS0160)。

摘　　要：目的系统评价乌司他丁联合血必净注射液治疗脓毒症的临床疗效。方法通过计算机检索中国知网(CNKI)、维普数据库(VIP)、万方数据库、EMbase、PubMed等中英文数据库。搜集2022年10月前发表的有关乌司他丁联合血必净注射液治疗脓毒症的中英文随机对照试验(RCTs),检索时间为2018年1月至2022年10月。由两位研究员各自独立的筛选符合纳入与排除标准的文献后汇总意见并提取相关资料,通过Cochrane偏倚风险评估工具对符合标准的文献质量进行评价。结果总共纳入17个RCT,包括1431例患者。meta分析结果显示,与单独使用乌司他丁治疗脓毒症患者相比,乌司他丁联合血必净注射液能够明显降低脓毒症患者的PCT(STD=-1.87,Z=6.85,P<0.01,95%CI:-2.40~-1.33),CRP(STD=-2.24,Z=5.51,P<0.01,95%CI:-3.04~-1.44),TNF-α(STD=-1.46,Z=9.16,P<0.01,95%CI:-1.78~-1.15),IL-6(STD=-1.38,Z=10.04,P<0.01,95%CI:-1.65~-1.11),APACHE-Ⅱ评分(MD=-3.24,Z=5.21,P<0.01,95%CI:-4.46~-2.02),机械通气时间(MD=-4.11,Z=3.33,P<0.01,95%CI:-6.52~-1.69),ICU住院时间(MD=-5.46,Z=6.72,P<0.01,95%CI:-7.05~-3.87),且临床疗效明显(PR=1.19,Z=4.32,P<0.01,95%CI:1.10~1.29)。结论乌司他丁联合血必净注射液治疗脓毒症患者优于单用乌司他丁治疗,且不良反应发生率低。Objective To systematically evaluate the clinical efficacy of ulinastatin combined with Xuebijing injection in the treatment of sepsis.Methods Chinese and English databases such as CNKI,VIP,Wanfang,EMbase and PubMed were searched by computer.Collect the Chinese and English randomized controlled trials(RCTs)on the treatment of sepsis with ulinastatin and Xuebijing injection published before October 2022.The retrieval time is from January 2018 to October 2022.The two researchers independently screened the literatures that met the inclusion and exclusion criteria,summarized their opinions and extracted relevant data,and evaluated the quality of the literatures that met the criteria through the Cochrane Bias Risk Assessment Tool.Results Totally 17 randomized controlled trials were included,including 1431 patients.Meta-analysis results show that compared with the treatment of sepsis patients with ulinastatin alone,ulinastatin combined with Xuebijing injection can significantly reduce the PCT of sepsis patients(STD=-1.87,Z=6.85,P<0.01,95%CI:-2.40--1.33),CRP(STD=-2.24,Z=5.51,P<0.01,95%CI:-3.04--1.44),TNF-α(STD=-1.46,Z=9.16,P<0.01,95%CI:-1.78--1.15),IL-6(STD=-1.38,Z=10.04,P<0.01,95%CI:-1.65--1.11),APACHE-Ⅱscore(MD=-3.24,Z=5.21,P<0.01,95%CI:-4.46--2.02),mechanical ventilation time(MD=-4.11,Z=3.33,P<0.01,95%CI:-6.52--1.69),ICU hospitalization time(MD=-5.46,Z=6.72,P<0.01,95%CI:-7.05--3.87),and the clinical effect is significant(PR=1.19,Z=4.32,P<0.01,95%CI:1.10-1.29).Conclusion Ulinastatin combined with Xuebijing injection is superior to Ulinastatin alone in the treatment of sepsis patients,and the incidence of adverse reactions is low.

关 键 词：乌司他丁 血必净 脓毒症或脓毒血症 META分析 

分 类 号：R459.7[医药卫生—急诊医学]