乌司他丁对感染性休克患者肾功能影响的Meta分析

发布时间：2019-03-05 10:29

【摘要】：目的系统评价乌司他丁对感染性休克患者肾功能的影响。方法计算机检索数据库Cochrane图书馆、Pub Med、EMbase、中国生物医学文献数据库、中国知网、万方和维普数据库,收集乌司他丁治疗感染性休克的随机对照试验,检索时间由建库至2015年。两名研究者对检索收集到的文献按照制定的纳入、排除标准进行独立筛选,采用Cochrane的偏倚风险评估标准评价文献质量。采用患者治疗后尿量、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)和γ-谷氨酰转移酶(γ-GTP)、血肌酐和尿素氮、连续性肾脏替代治疗比例作为评价结局的指标。采用Rev Man 5.3进行Meta分析。结果最终纳入符合标准的随机对照试验8项,总共410例患者。Meta分析结果显示:治疗第1、2、3日,乌司他丁组尿量高于对照组;治疗第1、3、5日,乌司他丁组尿NAG和γ-GTP水平低于对照组;治疗第1、2、3、5日,乌司他丁组血肌酐和尿素氮水平低于对照组,差异均有显著意义(P0.05)。乌司他丁组连续性肾脏替代治疗比例低于对照组(RR=0.50,95%CI:0.28~0.91,P=0.02)。结论乌司他丁对感染性休克患者的肾功能有改善作用。
[Abstract]:Objective to evaluate the effect of ulinastatin on renal function in septic shock patients. Methods A computer search database, Cochrane Library, Pub Med,EMbase, Chinese Biomedical Literature Database, China knowledge Network, Wanfang and Vip databases, was used to collect randomized controlled trials of ulinastatin in the treatment of septic shock. Retrieval time from the establishment of the library to 2015. Two researchers independently screened the collected literature according to the criteria of inclusion and exclusion, and evaluated the quality of the literature by using Cochrane's bias risk assessment standard. Urine volume, urine N-acetyl-尾-D-glucosaminidase (NAG) and 纬-glutamyltransferase (纬-GTP), serum creatinine and urea nitrogen) were used to evaluate the outcome of continuous renal replacement therapy. Rev Man 5.3 was used for Meta analysis. Results A total of 410 patients were enrolled in 8 randomized controlled trials. Meta analysis showed that the urine volume in Ulinastatin group was higher than that in control group on the 1st, 2nd and 3rd day after treatment. The levels of urinary NAG and 纬-GTP in the Ulinastatin group were lower than those in the control group at 1,3,5 days after treatment, and the serum creatinine and urea nitrogen levels in the Ulinastatin group were significantly lower than those in the control group at 1,2,3,5 days (P0.05). The percentage of continuous renal replacement therapy in ulinastatin group was lower than that in control group (RR=0.50,95%CI:0.28~0.91,P=0.02). Conclusion Ulinastatin can improve renal function in septic shock patients.
【作者单位】：重庆医科大学附属永川医院麻醉科;
【分类号】：R614

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