阿司匹林对脓毒症患者疗效的影响:一项系统性评价和荟萃分析  

Effect of Aspirin on Sepsis:A Systematic Review and Meta-Analysis

作　　者：石朝阳[1] 丁显飞 罗永刚[1] 韩冰[1] 张晓娟[1] SHI Chaoyang;DING Xianfei;LUO Yonggang;HAN Bing;ZHANG Xiaojuan(Comprehensive ICU,the First Affiliated Hospital of Zhengzhou University,Henan Key Laboratory of Critical Care Medicine,Zhengzhou Key Laboratory of Sepsis,Henan Engineering Research Center for Critical Care Medicine,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院综合ICU,河南省重症医学重点实验室,郑州市脓毒症重点实验室,河南省重症医学工程研究中心,河南郑州450052

出　　处：《河南医学研究》2024年第6期966-972,共7页Henan Medical Research

摘　　要：目的通过系统评价的方法,综合分析阿司匹林对脓毒症疗效的影响。方法系统性检索PubMed、Embase和The Cochrane Library 3个数据库,检索有关阿司匹林对脓毒症患者疗效影响的临床研究。根据预先设定的纳入和排除标准,筛选符合纳入标准的文章。主要研究结局为病死率,并采用随机效应模型和固定效应模型,以优势比(OR)和加权均数差(WMD)为效应量,各效应量以95%可信区间(CI)表示。使用纽卡斯尔-渥太华量表(NOS)评估纳入研究的质量。使用敏感性分析评估结果稳健性,使用漏斗图和Egger线性回归评估各纳入研究潜在的发表偏倚。使用Stata 12.0统计软件进行数据统计和分析。结果本研究共纳入14篇文章(148002例脓毒症患者),其中包括9篇队列研究,3篇随机对照研究和2篇前瞻性研究。阿司匹林能够降低脓毒症患者的30 d病死率、ICU病死率和院内病死率(P<0.05),但不能改善脓毒症患者的器官衰竭的发生率(P=0.308)和90 d病死率(P=0.267)。结论阿司匹林可降低脓毒症患者30 d病死率、ICU病死率和院内病死率,但不能改善脓毒症患者器官衰竭的发生率和90 d病死率。Objective To study the comprehensive analysis of the effect of aspirin on the efficacy of sepsis by using a systematic evaluation method.Methods Systematically search PubMed,Embase,and The Cochrane Library databases to search for clinical studies on the effects of aspirin on the efficacy of sepsis patients.Based on pre-set inclusion and exclusion criteria,select articles that meet the inclusion criteria.The main outcome of the study was case fatality rate,and a random effects model and a fixed effects model were used,with odds ratio(OR)and weighted mean difference(WMD)as the effect measures.Each effect measure was represented by a 95%confidence interval(CI).The quality of included studies using the Newcastle Ottawa scale(NOS)was evaluated.The robustness of the sensitivity analysis evaluation results,funnel chart and Egger linear regression evaluation were included in the potential publication bias of the study.Stata 12.0 statistical software was used for data statistics and analysis.Results A total of 14 articles(148002 patients with sepsis)were included in this study,of which 9 were cohort study,3 were randomized controlled studies and 2 were prospective studies.Aspirin can reduce the 30 day mortality rate,ICU mortality rate,and in-hospital mortality rate of sepsis patients(P<0.05),but it cannot improve the incidence of organ failure in sepsis patients(P=0.308)and 90 day mortality rate(P=0.267).Conclusion Aspirin can reduce the 30 day mortality rate,ICU mortality rate,and in-hospital mortality rate of sepsis patients,but it cannot improve the incidence of organ failure in sepsis patients and 90 day mortality rate.

关 键 词：脓毒症 阿司匹林 病死率 META分析 

分 类 号：R-1[医药卫生]