摘要
目的系统评价国内文献报道的血浆置换治疗慢性重型肝炎的疗效。方法 1)检索策略:检索中国生物医学文献数据库、中国期刊全文数据库、万方医药期刊数据库及维普中文科技期刊全文数据库2000～2010年公开发表的血浆置换治疗慢性重型肝炎的中文文献,同时通过与同事、专家和厂家联系获得同期未发表的同类中文文献资料(即灰色文献,包括学术报告、会议论文、毕业论文等);2)文献评价:按照严格的纳入/排除标准筛选符合标准的文献10篇,采用Cochrane协作网推荐的方法评价文献质量;3)统计学处理:采用Cochrane协作网提供的RevMan4.2软件做Meta分析。结果 10篇文献评价均为B或C级,为低质量研究;Meta分析显示:10项研究具有同质性[早期:chi2=3.01,df=9(P=0.96),I2=0%;中期:chi2=3.23,df=9(P=0.95),I2=0%;晚期:chi2=2.54,df=9(P=0.98),I2=0%];早、中、晚期慢性重型肝炎治疗组与对照组比较,其固定效应模型的合并比值比分别为:早期OR=4.06,95%CI为(2.60,6.35),Z=6.16(P<0.000 01);中期OR=3.04,95%CI为(2.18,4.24),Z=6.56(P<0.000 01);晚期OR=1.71,95%CI为(0.96,3.03),Z=1.83(P=0.07)。血浆置换治疗早中期慢性重型肝炎患者的疗效明显高于常规治疗组(P<0.000 01),晚期不明显(P=0.07>0.05)。结论与常规内科治疗相比,血浆置换能够有效提高早、中期慢性重型肝炎患者的疗效,而对晚期不明显。
Objective To assess the effectiveness of plasma exchange （PE） on patients with chronic severe hepatitis. Methods 1） Articles were been searched from Chinese Biomedicine Literature Database, CNKI, Wanfang Database and CQVIP Database from 2000 to 2010. In addition,unpubhshed data were also obtained from colleagues,peers and manufactures, such as plenary lectures, conference thesis, graduation thesis, etc. 2） Document assessment： There were 10 papers meeting the inclusion criteria. Papers were graded according to the Cochrane Collaboration＇ s method. 3） Statistical analysis：a total of 10 studies, meeting with the criteria, were subjected to meta-analysis using the RevMan5. 0 software developed by the Cochrane Collaboration. Results All the 10 perpers were of class B or C and of low levels of evidence. Meta-analysis showed that there were homogeneity [ earlier stage： chi^2 = 3.01, df = 9 （ P = 0. 96）, 12 = 0% ; intermediate stage： chi^2 = 3.23 ,df=9（P =0. 95） ,I^2 =0% ;advanced stage：chi^2 =2. 54,df=9（P =0.98） ,12 =0% ] among the 10 studies. For the fixed-effect model, OR of earlier period was 4.06,95% CI （ 2. 60,6. 35 ）, Z = 6. 16 （ P 〈 0. 000 01 ） ; OR of intermediate stage was 3.04,95% CI （2. 18,4.24） ,Z = 6. 56（ P 〈 0. 000 01 ） ; OR of advanced stage was 1.71,95% CI （0. 96,3. 03）, Z = 1.83 （ P = 0. 07）. The curative effect was higher for PE group than for conventional medication group in earlier and in- termediate stages of chronic severe hepatitis （P 〈 0. 000 01 ）, but not for advanced stage （P 〉 0. 05）. Conclusion PE is more effective in earlier and intermediate stages of chronic severe hepatitis than routine medical treatment, but not effective for advanced stage.
出处
《中国输血杂志》
CAS
CSCD
北大核心
2011年第11期924-928,共5页
Chinese Journal of Blood Transfusion
关键词
血浆置换
慢性重型肝炎
疗效
META分析
随机对照试验
人工肝
Plasma exchange
Chronic severe hepatitis
Therapeutic effect
Meta-analysis
Randomized controlled trial
Artificial liver support systems
