补充硫胺素对危重患者预后影响的meta分析  

Meta-analysis of effect of thiamine supplementation on prognosis in cri-tically ill patients

作　　者：李叶玲 陈旭 李铭 赵俐红[3] 杨蓉[2] LI Yeling;CHEN Xu;LI Ming;ZHAO Lihong;YANG Rong(Department of Critical Care Medicine,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Sichuan Province,Chengdu610041,China;Department of Neurology,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Sichuan Province,Chengdu610041,China;Department of Radiology,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Sichuan Province,Chengdu610041,China)

机构地区：[1]四川大学华西医院重症医学科/四川大学华西护理学院,四川成都610041 [2]四川大学华西医院神经内科/四川大学华西护理学院,四川成都610041 [3]四川大学华西医院放射科/四川大学华西护理学院,四川成都610041

出　　处：《中国医药导报》2024年第26期123-129,共7页China Medical Herald

基　　金：四川省科技厅区域创新合作项目(2023YFQ0099)。

摘　　要：目的基于随机对照试验(RCT)和倾向评分匹配(PSM)研究进行meta分析,以评估补充硫胺素对重症患者的影响。方法检索中国知网、万方数据知识服务平台、维普网、Scopus、PubMed、Cochrane和Embase数据库中建库至2024年5月发表的关于补充硫胺素对危重患者影响的RCT和PSM研究。对照组仅接受标准治疗,试验组则在对照组基础上,额外补充硫胺素。主要结局指标为患者病死率,次要结局指标包括重症监护病房住院时间及总住院时间。对纳入的RCT研究采用Cochran偏倚风险评估工具进行方法学质量评价;对纳入的PSM研究采用纽卡斯尔-渥太华量表进行方法学质量评价。运用RevMan 5.3版本软件进行meta分析,采用漏斗图评估纳入文献的发表偏倚。结果最终纳入了10项研究(6项RCT和4项PSM),包含5758例患者。meta分析结果发现,试验组病死率低于对照组(RR=0.79,95%CI:0.69~0.89,P=0.0002)。次要结局方面,试验组与对照组重症监护病房住院时间(MD=1.25,95%CI:-0.49~2.99,P=0.16)与总住院时间(MD=0.77,95%CI:-0.51~2.04,P=0.24)比较,差异均无统计学意义。结论在危重患者中,补充硫胺素与患者住院时间无关,但可降低患者病死率,改善预后。Objective To assess the effect of thiamine supplementation in critically ill patients based on a meta-analysis of randomized controlled trials(RCT)and propensity score matching(PSM)studies.Methods RCT and PSM studies on the effects of thiamine supplementation on critically ill patients published from inception to May 2024 in the CNKI,Wanfang Data,VIP,Scopus,PubMed,Cochrane,and Embase databases were searched.The control group was treated with basic treatment,and the experimental group was treated with thiamine supplement based on the control group.The main outcome measures were mortality,secondary outcome measures included intensive care unit stay and total length of stay.The two researchers conducted literature screening and data extraction independently,used the Cochran bias risk assessment tool to evaluate the methodological quality of the included RCT studies,and used the Newcastle-Ottawa score to evaluate the methodological quality of the included PSM studies.Meta-analysis was performed using RevMan 5.3 software,and funnel plot was used to assess publication bias in the included literature.Results A total of 10 studies(six RCT and four PSM)were ultimately included,with 5758 patients.Through the results of meta-analysis,it was found that mortality rate of experimental group was lower than that of control group(RR=0.79,95%CI:0.69 to 0.89,P=0.0002).In terms of secondary outcomes,the length of intensive care unit stay(MD=1.25,95%CI:-0.49 to 2.99,P=0.16)and the total length of hospital stay(MD=0.77,95%CI:-0.51 to 2.04,P=0.24)were not significantly different between the experimental group and the control group.Conclusion In critically ill patients,thiamine supplementation is not associated with length of hospital stay,but reduced mortality and improved prognosis.

关 键 词：重症 危重 硫胺素 META分析 

分 类 号：R472[医药卫生—护理学]