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第三军医大学大坪医院野战外科研究所输血科
纸质出版日期:2013,
网络出版日期:2013-03-30,
移动端阅览
武世文, 刘勇坚, 周洁, 等. 血浆置换治疗高脂血症胰腺炎临床效果的Meta分析[J]. 陆军军医大学学报, 2013,35(6):527-531.
WU SHIWEN, LIU YONGJIAN, ZHOU JIE, et al. Effect of plasma exchange on patients with hyperlipidemic pancreatitis: a meta-analysis. [J]. Journal of army medical university, 2013, 35(6): 527-531.
目的 系统评价血浆置换(plasma exchange
PE)治疗高脂血症胰腺炎的有效性。 方法 计算机检索PubMed、Medline、Cochrane Library、中国生物医学文献数据库、中国期刊全文数据库及维普中文科技期刊全文数据库,检索时限为建库至2012年8月,并辅以手工检索和文献追溯等方法获取血浆置换治疗高脂血症胰腺炎的相关文献;由2名独立的研究者严格按照Cochrane Reviewer’s Handbook进行文献筛选、文献评价和数据提取,采用RevMan 5.0软件对数据进行分析。 结果 共纳入文献11篇,累计414例患者,其中血浆置换治疗组(PE组)198例,常规综合治疗组(对照组)216例。Meta分析结果显示:与对照组相比,PE组明显提高了总体治愈率[
RR
=1.48
95%
CI
(1.19
1.85)
P
=0.000 5
]
,缩短了住院时间、禁食时间以及腹痛缓解时间,治疗后APACHEⅡ评分明显低于对照组,但两组总体病死率无统计学差异[
RR
=0.60
95%
CI
(0.29
1.24)
P
=0.17]。 结论 与常规综合治疗相比,PE是高脂血症胰腺炎患者有效的辅助治疗手段。但是目前所获文献方法学质量较低,需要进一步开展高质量、多中心、大样本的RCTs来评价血浆置换治疗高脂血症胰腺炎的有效性和安全性。
Objective To evaluate the efficiency of plasma exchange (PE) on patients with hyper-lipidemic pancreatitis. Methods Articles with key words of “plasma exchange or apheresis or pheresis or blood component removal or plasmapheresis” and “pancreatitis” were searched from Pubmed
Medline
Cochrane Library
Chinese Biomedicine Literature Database
CNKI and CQVIP Database from the time of their est
ablishment to August 2012. In addition
grey literatures about plasma exchange on patients with hyperlipidemic pancreatitis were manually searched. Two reviewers screened the literatures
then assessed the quality of each study and extracted data according the Cochrane Collaboration’s method independently. All data were analyzed by using the RevMan5.0 software. Results There were 11 trials meeting eligibility criteria
involving 414 cases. There were 198 cases of PE group and 216 cases of control group. Meta-analysis showed that PE significantly increased the overall cure rate (
RR
=1.48
95%
CI
=1.19 to 1.85
P
=0.000 5)
decreased the length of hospitalization and duration of fasting and abdominal pain, and the score acute physiology and chronic health evaluation (APACHE Ⅱ) after treatment. However
the difference in the overall mortality between PE group and control group was not statistically significant (
RR
=0.60
95%
CI
=0.29
1.24
P
=0.17). Conclusion Plasma exchange therapy is effective in hyperlipidemic pancreatitis than only routine medical treatment. But high-quality
multi-center
large-scale random control trials are required to identify the efficacy and safety of plasma exchange for hyperlipidemic pancreatitis.
血浆置换胰腺炎Meta分析高脂血症
plasma exchangepancreatitismeta-analysishyperlipemia
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