强化胰岛素治疗对急性脑卒中医院感染率影响的Meta分析

发布时间：2018-07-17 18:52

【摘要】：目的评价强化胰岛素治疗对急性脑卒中伴应激性高血糖患者医院感染率的影响。方法计算机检索PubMed、Embase、Cochrane Library、WanFang及CNKI Data数据库,同时手工检索相关专业杂志并追溯纳入文献的参考文献,按照统一的纳入和排除标准选择文献,系统评价强化胰岛素治疗急性脑卒中患者医院感染发生率与平均血糖。结果纳入13个随机对照试验(RCT),共1 032例患者。Meta分析结果显示,医院感染率比较最终纳入10个研究832例患者,强化组和常规组医院感染率分别为28.3%和56.1%,Z=4.50,两组差异有统计学意义[RR=0.53(95%CI:0.40~0.70),P0.001];血糖水平比较最终纳入5个研究328例患者,两组患者平均血糖差异有统计学意义[MD=-2.52(95%CI:-4.30~-0.74),P=0.006]。医院感染率漏斗图分析显示存在发表性偏倚。结论强化胰岛素治疗用于急性脑卒中伴应激性高血糖的调控,可降低医院感染率和患者血糖。
[Abstract]:Objective to evaluate the effect of intensive insulin therapy on nosocomial infection rate in acute stroke patients with stress hyperglycemia. Methods the online database of PubMeden Embase Cochrane Library Wan Fang and CNKI data were searched by computer, and the relevant professional journals were retrieved by hand and the references included in the literature were traced back, and the literature was selected according to the unified inclusion and exclusion criteria. Systematic evaluation of the incidence of nosocomial infection and mean blood glucose in patients with acute stroke treated with intensive insulin. Results in 13 randomized controlled trials (RCT), a total of 1032 patients. Meta analysis showed that the nosocomial infection rate was included in 832 patients in 10 studies. The nosocomial infection rate of the two groups was 28.3% and 56.1%, respectively, and the difference between the two groups was statistically significant [RRV 0.53 (95 CI: 0.40 / 0.70) P 0.001], and the blood glucose level of the two groups was significantly higher than that of the control group (MD-2.52 (95CIW -4.30U -0.74) P0. 006). Nosocomial infection rate funnel analysis showed that there was a published bias. Conclusion intensive insulin therapy can reduce the nosocomial infection rate and blood glucose in patients with acute stroke and stress hyperglycemia.
【作者单位】：上海市浦东新区浦南医院;海盐县中医院浙江省立同德医院海盐分院;浙江省立同德医院;
【基金】：上海市卫生和计划生育委员会科研基金(201440472) 浦东新区科技发展创新基金(PKJ2014-Y27)
【分类号】：R743.3

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