普萘洛尔预防肝硬化初次上消化道出血的meta分析

对普萘洛尔能否预防肝硬化上消化道出血进行系统评价。检索1980年1月至2000年12月期间发表的有关普萘洛尔预防肝硬化初次上消化道出血的随机对照临床试验。按照入选标准，有9项临床试验纳入本研究，由两名作者各自独立地对入选研究中有关试验设计、研究对象的特征、干预措施、研究结果等内容进行摘录，并用RevMan3.1软件进行分析。上消化道出血、死亡及因出血死亡的合并优势比（OR）分别为0.45[95%CI0.34，0.60]、0.73[95%CI0.55，0.96]、0.44[95%CI0.28，0.69]。肝功能越差，预防效果越差；腹水患者的预防效果亦较差。普萘洛尔可以预防肝硬化上消化道出血，并可降低总死亡率以及出血所致的死亡率。肝功能的状况和腹水的有无是影响普萘洛尔的预防效果的重要因素。

Propranolol in the prevention of the first upper gastrointestinal bleeding in patients with cirrhosis: a meta- analysis

To examine whether the first upper gastrointestinal bleeding in patients with cirrhosis may be prevented by propranolol. MEDLINE and China Biological Medicine Disk were searched for randomized controlled trials about studying the prevention of the first upper gastrointestinal bleeding by propranolol in cirrhosis patients from January 1980 to November 2000. According to included criteria, we choosed 9 studies at last. 2 authors drew details about trial design, characters of participants, interventions, results and so on from included studies independently. Data was analysed by RevMan3 1 software. The pooled OR of the first upper gastrointestinal bleeding, death and death caused by bleeding was 0 45 [95%CI 0 34,0 60],0 73[95%CI 0 55,0 96],0 44[95%CI 0 28,0 69]. The poorer the liver function is, the lacker the efficacy of propranolol. And the lower is the efficacy of propranolol in cirrhotic patients with ascites. Propranolol can prevent the first upper gastrointestinal bleeding in patients with cirrhosis, and also can reduce the rate of total death and death caused by bleeding. The liver function and ascites can affect propranolol in the prevention of the first upper gastrointestinal bleeding.