高血压脑出血患者IL-2、sIL-2R表达意义的研究

目的研究高血压脑出血患者外周血中白细胞介素2(IL-2)、可溶性白细胞介素2受体(sIL-2R)表达的变化规律,探讨其间相互关系及临床意义。方法采用酶联免疫吸附法(ELISA)测定患者IL-2、sIL-2R的含量。结果高血压脑出血组IL-2含量(pg/ml)为67.76±32.62,与健康对照组(127.15±57.05)相比明显降低(P<0.01),sIL-2R含量(pg/ml)为96.91±50.14,与健康对照组(92.11±34.1)相比则明显升高(P<0.05)。结论高血压脑出血患者出现免疫功能低下,临床检测患者IL-2、sIL-2R含量在高血压脑出血的发生、发展、治疗、转归及预后方面具有重要的临床指导意义。     

溃疡性结肠炎患者血清IL-2及sIL-2R浓度变化的研究

目的 研究白细胞介素2(IL-2)及可溶性白细胞介素2受体(sIL-2R)在溃疡性结肠炎(US)患者血清中浓度变化及与疾病活动性的关系。方法 用酶联免疫吸附法(ELISA)测定UC患者活动期、缓解期及正常对照者血清IL-2及sIL-2R的浓度。结果 32例UC患者活动期与缓解期及29例正常对照者比较,UC患者活动期外周血中IL-2的浓度显著降低,与缓解期组和正常对照组相比差异有均显著性(P<0.05);而外周血sIL-2R的浓度与缓解期组和正常对照组相比均显著升高(P<0.05)。结论 IL-2及sIL-2R在UC肠道的炎症病理中起重要作用,但具体机制有待于进一步研究。     

乳腺癌组织中c-erbB-2与pS2的临床意义及其关系

目的 探讨乳腺癌组织中c-erbB-2与pS2的表达及其相关性,并探讨其与乳腺癌临床病理特征以及与雌激素受体(ER)的相关性.方法 收集清华大学第一附属医院普外科2004年1月至2010年12月手术治疗并经病理检查确诊的乳腺癌患者标本79例,临床病理资料齐全.用免疫组织化学法检测79例乳腺癌标本中c-erbB-2与ps2的表达情况,分析不同临床病理特征与其表达的关系.结果 乳腺癌中c-erbB-2和pS2的阳性表达率分别是54.4％和59.5％.c-erbB-2的表达与淋巴结转移(D＜0.01)、组织学分级(P＜0.05)、TNM分期(P＜0.05)关系均具有统计学意义;pS2的表达与绝经状况(P＜0.01)与年龄(P＜0.05)关系有统计学意义.ER(+)组c-erbB-2的阳性表达率低于ER( -)组(P＞0.05),ER(+)组pS2的阳性表达率高于ER(-)组(44.4％,8/18),pS2(+)组c-erbB-2的阳性表达率高于pS2(-)组(P＜0.05).结论 联合检测乳腺癌组织中c-erbB-2及pS2的表达对于判断乳腺癌预后和指导治疗具有重要的临床价值.     

E2F2表达水平与前列腺癌患者的预后及免疫浸润的相关性

【目的】探讨E2F2表达水平与前列腺癌患者的预后及免疫浸润的相关性。【方法】基于癌症和肿瘤基因图谱(TCGA)数据库,分析E2F2在前列腺癌中的表达情况,通过基因集富集分析和免疫浸润分析E2F2表达水平与前列腺癌患者预后的相关性,采用受试者工作特征(ROC)曲线分析E2F2诊断前列腺癌的价值。【结果】E2F2在前列腺癌肿瘤组织中表达水平高于前列腺正常组织,差异有统计学意义(P<0.001);前列腺癌肿瘤组织E2F2表达水平高于癌旁正常组织,差异有统计学意义(P<0.001)。T3~4分期的前列腺癌患者E2F2表达水平高于正常组织及T_(2)分期,N_(1)分期的E2F2表达水平高于正常组织及N0分期,差异有统计学意义(P<0.05);不同M分期及不同预后患者E2F2表达水平比较,差异无统计学意义(P>0.05)。Kaplan-Meier生存分析显示,E2F2表达水平与前列腺癌患者的总生存率、无进展间隔均呈负相关(均P<0.05);E2F2表达水平与前列腺癌患者的疾病特异性生存率无显著相关性(P>0.05)。ROC曲线分析显示,E2F2诊断前列腺癌的AUC为0.731(95%CI为0.653~0.809)。Spearman相关性分析显示,E2F2表达水平与T辅助淋巴细胞2、T辅助淋巴细胞、树突状细胞、T细胞富集群呈正相关(均P<0.05);E2F2表达水平与自然杀伤细胞、肥大细胞富集群呈负相关(均P<0.05)。【结论】前列腺癌患者E2F2表达水平显著升高,E2F2过表达与预后不良及细胞免疫浸润密切相关。     

血清MMP-2、TIMP-2水平与心力衰竭发展关系的研究

目的观察心力衰竭患者血清基质金属蛋白酶-2(MMP-2)、组织金属蛋白酶抑制因子-2(TIMP-2)水平变化与心力衰竭的关系。方法采用酶联免疫吸附法分别检测50例心力衰竭患者血浆MMP-2、TIMP-2水平,并与临床病理资料进行对比分析。结果 MMP-2在NYHA12、级组表达水平明显高于NYHA3、4级;在左心室射血分数(LVEF)≤50%组表达水平明显低于LVEF>50%组;E/A≤1组明显低于E/A>1组;冠脉病变Ⅲ、Ⅳ型组明显低于冠脉病变Ⅰ、Ⅱ型组;在血脂异常组和血脂正常组患者间无显著差异。TIMP-2在NYHA12、级组表达水平明显低于NY-HA34、级;在左心室射血分数(LVEF)≤50%组表达水平明显高于LVEF>50%组;E/A≤1组明显高于E/A>1组;冠脉病变Ⅲ、Ⅳ型组明显高于冠脉病变Ⅰ、Ⅱ型组;在血脂异常组和血脂正常组患者间无明显差别。MMP-2水平与患者冠脉病变支数(r=0.76845 P<0.05)、冠脉病变程度(r=0.5640,P<0.01)、左室舒张末期内径(r=0.6088,P<0.01)、射血分数(r=0.7004,P<0.01)之间存在相关;TIMP-2水平与冠脉病变程度(r=0.5609,P<0.01)、左室射血分数(r=0.4652,P<0.01)之间存在相关;MMP-2、TIMP-2之间不存在明显相关(r=-0.2674,P>0.05)。结论 MMP-2、TIMP-2在心力衰竭患者不同阶段表现不同,检测两者的变化可动态观察患者的预后。     

西北地区非糖尿病人群IGF2BP2基因多态性与胰岛素抵抗的相关性分析

目的探讨中国西北汉族人群胰岛素样生长因子2结合蛋白2(IGF2BP2)基因多态性与2型糖尿病(T2DM)及其表型的关系。方法采用病例-对照研究方法,随机选取374例T2DM患者和360例非糖尿病对照人群,应用基质辅助激光解吸电离飞行时间质谱(MALDI-TOFMS)技术对病例组及对照组IGF2BP2基因多态位点rs4402960进行基因分型。结果 rs4402960位点T等位基因频率在T2DM组及对照组分别为29.6%和27.2%,两组间差别无统计学意义;基因-表型研究显示对照组中携带TT与TG基因型的人群其稳态模型下胰岛素抵抗(HOMA-IR)、空腹胰岛素(FINS)及餐后2h胰岛素(PINS)的上四分之三位数值具有高于GG基因型的趋势,Logistic回归发现经校正年龄、性别及体重指数(BMI)后,显性遗传模型下rs4402960位点与胰岛素抵抗相关(OR=1.76,95%CI:1.05～2.97,P=0.033)。结论西北汉族人群中IGF2BP2基因rs4402960位点与T2DM无明显关联,但该位点可能与胰岛素抵抗相关。     

环氧化酶-2基因多态性与2型糖尿病的相关性研究

目的探讨环氧化酶(COX)基因-765G/C和-1195G/A多态性与2型糖尿病(T2DM)的相关性。方法采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)和全自动临床生化分析仪法,对120例T2DM患者和92例健康对照者的COX-2基因多态性和常用临床指标进行检测,比较分析两组间基因型频率和等位基因频率及其临床资料。结果 T2DM组的血糖、餐后2h血糖、TG均高于对照组,差异有统计学意义(P<0.05);而HDL-C、载脂蛋白(Apo)AⅠ均低于对照组,差异有统计学意义(P<0.05);两组-1195G/A位点基因型的频率比较,差异有统计学意义(P<0.05)。结论 COX-2基因-1195G/A多态性可能与皖北地区T2DM的发病相关。     

A-aDO2及A-aDO2/FiO2在SARS患者血气分析中的意义

目的探讨肺泡-动脉血氧分压差(A-aDO2)在SARS患者血气分析中的意义.方法对116例患者的血气分析进行检测,以氧合指数分成4组,正常组≥400mmHg,轻度肺损伤300～400mmHg,急性肺损伤(ALI)＜300mmHg,急性呼吸窘迫综合征(ARDS)＜200mmHg.取A-aDO2与FiO2的比值,观察其数值的变化情况.结果在SARS患者,其A-aDO2、A-aDO2/FiO2平均值在4组中有明显差异,随着氧合指数的下降,A-aDO2/FiO2呈明显上升趋势.结论随着肺损伤的加重A-aDO2值明显增加,其与FiO2的比值与氧合指数呈负相关,是提示SARS患者肺损伤、病情轻重的有效指标.     

GTF2H2的核苷酸切除修复功能对肝癌细胞增殖和凋亡的影响

目的探讨通用转录因子ⅡH亚基2(GTF2H2)在肝癌细胞中的核苷酸切除修复(NER)功能及对肝癌细胞增殖和凋亡的影响。方法使用siRNA构建GTF2H2敲低的肝癌细胞模型,采用细胞计数试剂盒(CCK8)实验检测肝癌细胞的增殖能力;流式细胞术检测肝癌细胞株的凋亡情况。定量实时聚合酶链式反应(q-RT-PCR)检测增殖细胞核抗原(PCNA)和凋亡蛋白半胱天冬酶(Caspase-3)的表达情况。进一步构建肝癌细胞的紫外线(UV)照射模型,分析GTF2H2敲低后UV照射引起的NER的标志物环丁烷嘧啶二聚体(CPD)和嘧啶(6-4)嘧啶酮光产物(6-4PP)的变化。结果GTF2H2敲低的肝癌细胞增殖能力相对明显增强增殖蛋白PCNA的表达相对增多。相反,凋亡能力相对减弱凋亡蛋白Caspase-3的表达相对降低。而GTF2H2敲低后,UV照射所致的NER标志物CPD和6-4PP含量相对增加。结论GTF2H2在肝癌细胞中发挥了NER功能,抑制了肝癌细胞的增殖,促进其凋亡,是肝癌发生的一个潜在抑制因子。     

乳腺癌环氧合酶-2和基质金属蛋白酶-2及其抑制因子的表达

目的 研究环氧合酶(COX)-2、基质金属蛋白酶(MMP)-2及其抑制因子(TIMP-2)在乳腺癌组织中的蛋白表达及其相互关系.方法 建立组织芯片平台,应用免疫组织化学S-P法检测127例乳腺癌组织COX-2、MMP-2和TIMP-2蛋白的表达情况.结果 乳腺癌COX-2、MMP-2和TIMP-2阳性率分别为81.1%(103/127)、96.9%(123/127)和60.6%(77/127);COX-2的表达与乳腺癌腋淋巴结转移和TNM分期均呈正相关(P<0.01,P<0.05),与孕激素受体表达呈负相关(P<0.05);MMP-2蛋白表达与COX-2表达呈显著正相关(r=0.290,P<0.01).结论 乳腺癌COX-2表达状况与肿瘤侵袭转移有密切关系,COX-2可能通过调控MMP-2表达来促进肿瘤侵袭转移.     

SGLT2 inhibitors in patients with type 2 diabetes and renal disease: overview of current evidence

Chronic kidney disease (CKD) is a frequent complication of type 2 diabetes mellitus (T2DM) and is associated with poor clinical outcomes, including an increased risk of all-cause and cardiovascular mortality, as well as adverse economic and social effects. Slowing the development and progression of CKD remains an unmet clinical need in patients with T2DM. Sodium-glucose co-transporter 2 (SGLT2) inhibitors are widely used for the management of T2DM and have effects beyond glucose lowering that include cardiovascular benefits and potential renoprotective effects. Although the glucose-lowering efficacy of these agents is dependent on renal function, the cardiovascular and renal benefits of SGLT2 inhibition appear to be maintained to estimated glomerular filtration levels as low as 30 mL/min/1.73 m². Clinical evidence has indicated that these agents can reduce the risk of development or worsening of albuminuria, a marker of renal damage, through a range of mechanisms. These include blood pressure lowering, reduction of intraglomerular pressure and hyperfiltration, modification of inflammatory processes, reduction of ischemia-related renal injury, and increases in glucagon levels. The blood pressure-lowering effect of SGLT2 inhibitors is maintained in people with CKD and could further contribute to reduced renal burden, as well as potentially offering synergistic effects with antihypertensive therapies in these patients. Several cardiovascular outcomes trials (CVOTs) have included renal endpoints, adding to the growing evidence of the potential renoprotective effects of these agents in patients with T2DM. Several ongoing dedicated renal outcomes trials will provide further guidance on the potential clinical role of SGLT2 inhibitors in slowing the development and progression of renal impairment in individuals with T2DM.     

Sodium-glucose cotransporter 2 inhibitors and cardiovascular outcomes

Type 2 diabetes mellitus (T2DM) is associated with an elevated risk of cardiovascular (CV) morbidity and mortality. Furthermore, many patients with T2DM have comorbidities that are risk factors for CV disease. While intensive glucose control reduces the risk of diabetic microvascular complications, its relationship to CV outcomes remains unclear. Consequently, the management of CV risk factors in patients with T2DM is complex, and factors other than blood glucose must be considered. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, a class of oral glucose-lowering agents, are associated with reductions in blood pressure and body weight, in addition to decreasing hyperglycemia, and therefore have the potential to reduce CV risk in patients with T2DM. The clinical trial results of SGLT2 inhibitors regarding CV safety and outcomes are discussed, including data from the recently published EMPA-REG OUTCOME study. This trial was the first dedicated CV outcomes study to demonstrate that a glucose-lowering agent lowered CV mortality and all-cause mortality, and reduced hospitalization for heart failure in patients with T2DM at high risk of CV events.     

Glycemic control of type 2 diabetes mellitus across stages of renal impairment: information for primary care providers

Chronic kidney disease (CKD) is a frequent complication of type 2 diabetes mellitus (T2DM) and elevates individuals’ risk for cardiovascular disease, the leading cause of morbidity and mortality in T2DM. Achieving and maintaining tight glycemic control is key to preventing development or progression of CKD; however, improving glycemic control may be limited by effects of renal impairment on the efficacy and safety of T2DM treatments, necessitating dosing adjustments and careful evaluation of contraindications. Understanding the treatment considerations specific to each class of T2DM medication is important in individualizing therapy and improving glycemic, renal, and cardiovascular outcomes.

Traditional glucose-lowering treatments include insulin, metformin, sulfonylureas, meglitinides, and thiazolidinediones. Each of these agents exhibits altered pharmacokinetics in patients with renal impairment except for the thiazolidinediones, which are metabolized by the liver and do not accumulate appreciably in patients with renal impairment. Newer glucose-lowering treatments include GLP-1 receptor agonists, DPP-4 inhibitors, and SGLT2 inhibitors. Of these, only the DPP-4 inhibitor linagliptin can be used across all stages of renal impairment without dosing restrictions or concerns regarding dose escalation, and all SGLT2 inhibitors are contraindicated when eGFR <45 mL/min/1.73m². Several of the newer treatments have also been investigated for effects on renal and cardiovascular outcomes, demonstrating potential benefits of the GLP-1 agonists liraglutide and semaglutide, as well as the SGLT2 inhibitors canagliflozin and empagliflozin, in reducing risk for some adverse renal and cardiovascular events. In addition, some DPP-4 inhibitors have been shown to reduce albuminuria, an indicator of glomerular dysfunction. Consideration of this information is useful in informing optimal management strategies for patients with T2DM and concomitant CKD. More clinical data from future and ongoing clinical trials, including data regarding potential renal and cardiovascular benefits, will be important in clarifying the safety and efficacy profiles of each of these agents in patients with CKD.     

The use of sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes and hypertension: a focus on African-American populations

Diabetes, hypertension, and severe kidney disease are all disproportionately prevalent in African-Americans. Clinical trials data from type 2 diabetes (T2D) patients have demonstrated that sodium-glucose cotransporter 2 (SGLT2) inhibitors have a positive effect on cardiovascular risk factors – such as improved blood glucose control, reduced body weight, and reduced blood pressure – and also support a possible renal-protective role for SGLT2 inhibitors. The EMPA-REG OUTCOME^® trial revealed that empagliflozin was associated with reduced adverse cardiovascular and renal outcomes. Thus, SGLT2 inhibitors could potentially provide clinicians with a treatment option that addresses multiple pathophysiologic aspects of the cardiometabolic disease processes that may affect end-organ function in African-American patients with T2D and hypertension. This review examines some of the clinical issues associated with this patient group and the role that SGLT2 inhibitors may provide in their treatment.     

Medical evaluation of Indochinese refugees

Abstract

Most patients with type 2 diabetes mellitus (T2DM) are overweight or obese. Both T2DM and overweight/obesity are associated with increased patient risk of cardiovascular events and mortality. Despite being the recognized cornerstone of treatment, weight loss and maintenance of weight loss are difficult for patients with T2DM, particularly as treatments for T2DM may cause weight gain. Sodium glucose cotransporter 2 (SGLT2) inhibitors, a new class of drug for the treatment of patients with T2DM, reduce renal glucose reabsorption, resulting in urinary glucose excretion. Due to the caloric loss associated with decreased glucose in urine, treatment with SGLT2 agents offers the benefit of weight loss to patients, as well as reduction in hyperglycemia. Clinical trials of SGLT2 inhibitors in patients with T2DM, ranging in length from 4 to 90 weeks, have shown patient weight reductions from baseline of up to 4.7 kg. Such weight loss may have beneficial effects on adherence to medication, glycemic control, and cardiovascular risk in patients with T2DM.     

The kidney and type 2 diabetes mellitus: therapeutic implications of SGLT2 inhibitors

Understanding the role of the kidneys in type 2 diabetes mellitus (T2DM) has taken on an increased importance in recent years with the arrival of sodium–glucose co-transporter 2 (SGLT2) inhibitors — antihyperglycemic agents (AHAs) that specifically target the kidneys. This review includes an update on the physiology of the kidneys, their role in the pathophysiology of T2DM, and the mechanisms implicated in the development and progression of diabetic kidney disease, such as glomerular hyperfiltration and inflammation. It also discusses renal issues that could influence the choice of AHA for patients with T2DM, including special populations such as patients with concomitant chronic kidney disease. The most recent data published on the clinical efficacy and safety of the SGLT2 inhibitors canagliflozin, dapagliflozin, and empagliflozin and their effects on renal function are presented, showing how the renally mediated mechanisms of action of these agents translate into clinical benefits, including the potential for renoprotection. The observed positive effects of these agents on measures such as glucose control, estimated glomerular filtration rate, albumin-to-creatinine ratio, blood pressure, and body weight in patients both with and without impaired renal function suggest that SGLT2 inhibitors represent an important extension to the diabetes treatment armamentarium.     

Efficacy and renal outcomes of SGLT2 inhibitors in patients with type 2 diabetes and chronic kidney disease

Objective: To review glucose-lowering efficacy and changes in renal function associated with sodium-glucose co-transporter 2 (SGLT2) inhibitors among patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM).

Data sources: A literature search of MEDLINE and Cochrane databases was performed from 2000 to August 2018 using search terms: SGLT2 inhibitors, sodium glucose co-transporter 2, canagliflozin, empagliflozin, dapagliflozin, ertugliflozin, and chronic kidney disease. References of identified articles were also reviewed.

Study selection and data extraction: English-language studies investigating glucose-lowering endpoints and/or changes in renal function with one of four U.S. approved SGLT2 inhibitors were included. A total of 10 studies met inclusion criteria and are included in this review.

Results: In patients with T2DM and CKD, SGLT2 inhibitors are modestly effective in lowering hemoglobin A1C and fasting plasma glucose compared to placebo. Small reductions in eGFR are seen shortly after initiating therapy with SGLT2 inhibitors, but return to baseline levels after discontinuation. SGLT2 inhibitors are associated with a substantial reduction in albuminuria and reduced risk of progression to albuminuria.

Conclusions: In patients with T2DM and CKD, SGLT2 inhibitors have a decreased glucose-lowering effect compared to patients without CKD. Renal benefits among patients with CKD are similar to those without CKD and include a significant reduction in albuminuria and reduced incidence of worsening albuminuria. Given that CKD and T2DM are both associated with increased cardiovascular risk, we believe these agents should considered as preferred add-on agents in most patients with uncontrolled T2DM and eGFR >30 ml/min/1.73 m². Ongoing studies will provide additional information as to whether these agents should be added to the current standard of care for CKD patients, with and without T2DM.     

血管紧张素受体阻滞剂与血管紧张素转换酶抑制剂治疗冠心病患者有效性与安全性的Meta分析

目的系统评价血管紧张素受体阻滞剂(ARB)与血管紧张素转换酶抑制剂(ACEI)比较治疗冠心病的疗效和安全性,为临床应用提供证据。方法计算机检索MEDLINE、EMbase、BIOSIS Previews、Cochrane图书馆、CBM、VIP、WanFang Data和CNKI数据库,检索时限从建库至2011年7月,同时追索纳入文章的参考文献,纳入有关ACEI与ARB比较治疗冠心病的随机对照试验。由两名研究者按纳入与排除标准,独立选择文献、提取资料和评价质量并交叉核对后,采用RevMan 5.1.1软件进行Meta分析。结果纳入18个RCT,共17 660例患者。Meta分析结果显示,在全因死亡[RR=1.04,95%CI(0.98,1.11),P=0.20]、心血管死亡[RR=1.04,95%CI(0.97,1.12),P=0.26]、心肌梗死[RR=0.98,95%CI(0.92,1.05),P=0.59]、因心衰住院[RR=1.14,95%CI(0.97,1.32),P=0.11]和脑卒中[RR=0.93,95%CI(0.80,1.08),P=0.34]方面,ARB与ACEI的差异无统计学意义;但ARB在因不良反应而停药[RR=0.77,95%CI(0.67,0.89),P=0.000 3]方面优于ACEI。结论 ARB治疗冠心病在全因死亡、心血管死亡、心肌梗死、因心衰而住院、脑卒中等方面,疗效与ACEI相当且耐受性更好。但受纳入研究质量和样本量所限,上述结论仍需更多大样本、多中心、前瞻性临床研究证实。     

中国人群脂联素基因+276G/T位点多态性与T2DM易感性的Meta分析

目的 探讨中国人群脂联素基因+276G/T位点多态性与2型糖尿病(T2DM)的相关性.方法 检索2011年8月前中国知网、维普中文科技期刊全文数据库、中国万方数据库、中国学位论文全文数据库和中国重要会议论文全文数据库及Medline、Cochrane Library、Embase、Springer、Ovid等数据库,收集有关中国人群脂联素基因+276G/T位点多态性与T2DM相关性研究的文献;评价纳入研究质量,提取有效数据,采用Review Manager 5.0软件进行Meta分析.结果 共纳入11项研究中国人群脂联素基因+276G/T位点多态性与T2DM相关性的病例对照研究;T2DM患者1 697例,健康对照者1 341例.Meta分析结果显示,脂联素基因+276G/T位点G/T多态性与T2DM的相关性中T等位基因与G等位基因(OR=0.83,95% CI为0.65～1.05,P=0.12)、基因型(GT+TT)与GG(OR=0.82,95% CI为0.60～1.12,P=0.20)、基因型GT与GG(OR=0.93,95%CI为0.63～1.38,P=0.72)、基因型TT与GG(OR=0.81,95%CI为0.46～1.42,P=0.46)比较,差异均无统计学意义.结论 中国人群脂联素基因+276G/T位点多态性可能与T2DM易感性无关.     

姑息照护在心力衰竭患者中应用效果的系统评价

目的系统评价姑息照护干预心力衰竭患者的疗效。方法计算机检索PubMed、EMbase、CINAHL、The Cochrane Library、VIP、CNKI、CBM和WanFang Data数据库,搜集关于姑息照护干预心衰患者疗效的随机对照试验(RCT),检索时限均为建库至2021年9月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入11个RCT,包括912例患者。Meta分析结果显示,姑息照护可提高心力衰竭患者的生活质量[KCCQ或McGill QoL量表:SMD=0.85,95%CI(0.13,1.58),P=0.02;MLHFQ量表:SMD=-1.32,95%CI(-2.10,-0.54),P=0.0009]、降低患者抑郁水平[SMD=-0.58,95%CI(-0.87,-0.28),P=0.0001]与焦虑水平[SMD=-0.51,95%CI(-0.89,-0.13),P=0.008]、改善不良症状[SMD=-1.46,95%CI(-2.67,-0.24),P=0.02],减少人均住院时间[MD=-0.94,95%CI(-1.28,-0.60),P<0.00001]和降低再入院率[RR=0.64,95%CI(0.42,0.98),P=0.04],但对于患者的死亡率[RR=1.00,95%CI(0.63,1.57),P=0.99]并无明显影响。结论当前有限证据表明,姑息照护可改善心衰患者生活质量、情绪状态、不良症状,减少住院时间和降低再入院率。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。