抗凝治疗对急性呼吸窘迫综合征疗效及预后影响的Meta分析  

Meta⁃analysis of the therapeutic effect and prognostic impact of anticoagulant therapy on acute respiratory distress syndrome

作　　者：向婷 邓医宇 XIANG Ting;DENG Yiyu(Dept.of Critical Care Medicine,Guangdong Provincial People's Hospital of Southern Medical University&Guangdong Academy of Medical Sciences,Guangzhou 510080,Guangdong,China)

机构地区：[1]南方医科大学附属广东省人民医院/广东省医学科学院重症医学科,广东广州510080

出　　处：《武汉大学学报(医学版)》2025年第2期205-211,共7页Medical Journal of Wuhan University

基　　金：国家重点研发计划项目(编号:2021YFC2501800)。

摘　　要：目的:系统评价急性呼吸窘迫综合征(ARDS)患者抗凝治疗的疗效及预后。方法:检索PubMed、Cochrane Library、Embase、Web of Science、中国知网数据库,检索时间为各数据库建库起至2024年6月,纳入肝素/低分子肝素对比安慰剂或其他药物治疗ARDS的随机对照试验(RCT),采用Revman 5.1统计软件进行Meta分析。结果:共纳入7项RCT 513例ARDS患者。与对照组相比,肝素/低分子肝素治疗组的患者氧合指数显著改善(RR=10.46,P<0.01);ICU住院天数显著缩短(RR=5.58,P<0.01);机械通气时间缩短(RR=5.54,P<0.01);APTT时间无显著差异(RR=1.21,P=0.23)。结论:肝素/低分子肝素抗凝治疗可有效改善成人ARDS患者的氧合指数,缩短ICU住院时间、机械通气天数。Objective:To systematically evaluate the efficacy and prognosis of anticoagulant therapy in pa-tients with acute respiratory distress syndrome(ARDS).Methods:We searched PubMed,Cochrane Library,Embase,Web of Science,and China National Knowledge Infrastructure databases from the inception of each database to June 2024,for randomized controlled trials(RCTs)comparing heparin/low molecular weight heparin to placebo or other drug treatments for ARDS.Meta-analysis was con-ducted using Revman 5.1 statistical software.Results:A total of 7 RCTs involving 513 ARDS pa-tients were included.Compared with the control group,the heparin/low molecular weight heparin treatment group showed significant improvement in oxygenation index(RR=10.46,P<0.01),a sig-nificant reduction in ICU stays(RR=5.58,P<0.01),and a shorter duration of mechanical ventila-tion(RR=5.54,P<0.01).However,there was no significant difference in APTT time(RR=1.21,P=0.23).Conclusion:Anticoagulant therapy with heparin or low molecular weight heparin can effectively improve the oxygenation index in adult ARDS patients,shorten ICU stays,and reduce the duration of mechanical ventilation.

关 键 词：急性呼吸窘迫综合征 急性肺损伤 肝素/低分子肝素 META分析 

分 类 号：R459.4[医药卫生—治疗学]