国内奥曲肽与乌司他丁联用治疗急性胰腺炎效果的Meta分析

目的系统评价国内奥曲肽与乌司他丁联用治疗急性胰腺炎的疗效和安全性。方法计算机检索CBM、VIP、CNKI和WanFang Data,查找有关应用奥曲肽与乌司他丁联用治疗急性胰腺炎的随机对照试验(RCT),并追索纳入文献的参考文献,检索时限均为建库至2011年2月。由2名评价者独立选择试验、提取资料和评估方法学质量后,采用RevMan 5.1软件进行Meta分析。结果最终纳入12个研究,共1 023例受试者。Meta分析结果显示:奥曲肽与乌司他丁联用在以下方面均优于常规治疗或单用二者之一,且差异有统计学意义:总有效率RR=0.34,95%CI(0.23,0.52)],腹痛和腹胀缓解时间SMD=–0.89,95%CI(–1.09,–0.70)],体征(主要为腹部压痛)缓解时间SMD=–0.95,95%CI(–1.48,–0.42)],平均住院时间SMD=–1.10,95%CI(–1.58,–0.63)],血淀粉酶恢复正常时间SMD=–1.14,95%CI(–2.10,–0.17)],疗程结束时阳性例数RR=0.20,95%CI(0.08,0.51)],尿淀粉酶恢复正常时间SMD=–0.86,95%CI(–1.04,–0.68)]和治疗结束时阳性例数RR=0.27,95%CI(0.12,0.63)],治疗结束时IL-6水平SMD=–2.25,95%CI(–4.39,–0.11)],并发症的发生率RR=0.39,95%CI(0.28,0.55)],转手术率RR=0.41,95%CI(0.24,0.69)],病死率RR=0.43,95%CI(0.29,0.64)];而在血钙恢复正常时间上稍长于常规治疗或单用二者之一,但差异无统计学意义MD=0.15,95%CI(0.05,0.26)]。结论本Meta分析结果提示,奥曲肽与乌司他丁联用优于常规治疗或二者之一单用,从而为当前国内急性胰腺炎的治疗提供了一种新的治疗选择,在临床上具有良好的应用前景。但由于纳入研究样本量小且质量较低,上述结论尚需要高质量、大样本的随机盲法对照试验加以证实。

Effectiveness and Safety of Octreotide Combined with Ulinastatin for Treating Acute Pancreatitis in China: A Meta-Analysis

Objective To evaluate the effectiveness and safety of Octreotide combined with Ulinastatin for treating acute pancreatitis in China.Methods The databases such as CBM,VIP,CNKI and WanFang Data were searched to collect randomized controlled trials(RCTs) from the date of their establishment to February 2011,and the relevant references of the included studies were also retrieved.Studie were screened,data were extracted,and the methodological quality was assessed by two reviewers independently.Meta-analyses were...