糖皮质激素对慢性重度乙型肝炎疗效及安全性的Meta分析

发布时间：2018-03-21 17:10

本文选题：糖皮质激素类　切入点：肝炎　出处：《重庆医学》2015年24期 　论文类型：期刊论文

【摘要】：目的系统评价糖皮质激素对慢性重度乙型肝炎的疗效及安全性。方法计算机检索PubMed、Cochrane Library、中国知网、中国生物医学文献数据库、维普、万方等数据库中糖皮质激素治疗慢性重度乙型肝炎的随机对照试验,由两名研究者按照纳入与独立筛选文献、提取资料、评价质量并交叉核对后,采用RevMan 5.2软件进行Meta分析。结果共纳入6篇文献,共计502例患者。Meta分析结果显示:与一般治疗对照组相比,糖皮质激素不能提高治疗有效率[RR=1.13,95%CI(0.95,1.34),P=0.17];但能显著降低生化指标谷丙氨酸转氨酶[MD=-21.34,95%CI(-42.56,-0.11),P=0.05]和总胆红素[MD=-39.88,95%CI(-52.38,-27.38),P0.01];能显著升高清蛋白水平[MD=4.60,95%CI(3.33,5.87),P0.01]和凝血酶原活动度[MD=5.09,95%CI(2.90,7.72),P0.01];能显著降低重型肝炎发生率[RR=0.33,95%CI(0.20,0.54),P0.01];漏斗图结果显示存在发表偏倚。结论糖皮质激素治疗慢性重度乙型肝炎较一般治疗相比效果显著,同时可减少重型肝炎发生率,在综合治疗的基础上合理使用激素不增加不良反应发生率。
[Abstract]:Objective to systematically evaluate the efficacy and safety of glucocorticoids in the treatment of chronic severe hepatitis B. methods the online search of PubMedCochrane Library, Chinese Biomedical Literature Database, Weip, and other methods were used to evaluate the efficacy and safety of glucocorticoid in patients with chronic hepatitis B. A randomized controlled trial of glucocorticoid in the treatment of chronic and severe hepatitis B in Wanfang and other databases was carried out by two researchers according to the inclusion and independent screening of literature, the data were extracted, the quality was evaluated and cross-checked. Meta analysis was carried out with RevMan 5.2 software. Results A total of 502 patients were included in 6 articles. Meta-analysis results showed that: compared with the control group of general treatment, Glucocorticoid can not improve the effective rate of treatment [RRR1.13995 CI0.951.34P0.17], but it can significantly decrease the biochemical index glutamic alanine aminotransferase [MD-21.3495CI-42.56CI-0.11CI-0.05] and total bilirubin [MD-39.895 CI-52.388-27.38P0.01]; can significantly increase the level of albumin [MD4.60,95CI3.35.87P0.01] and prothrombin activity [MD5.0995CI2.907.72hu P0.01]; and can significantly reduce the occurrence of severe hepatitis. The results of funnel graph showed that there was a bias of publication. Conclusion the effect of glucocorticoid on treatment of chronic and severe hepatitis B is more significant than that of general treatment. At the same time, it can reduce the incidence of severe hepatitis, on the basis of comprehensive treatment, the rational use of hormones does not increase the incidence of adverse reactions.
【作者单位】：兰州大学第二临床医学院;兰州大学第一临床医学院;兰州大学第二医院消化内科;
【基金】：兰州大学大学生创新创业项目(20141073001072)
【分类号】：R512.62

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