糖皮质激素对脓毒性休克的疗效及预后Meta分析

高沪; 李熙鸿

doi:10.16016/j.1000-5404.201710157

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糖皮质激素对脓毒性休克的疗效及预后Meta分析

公共卫生与预防医学 | 更新时间：2026-01-09

- 糖皮质激素对脓毒性休克的疗效及预后Meta分析
- Efficacy and prognosis of glucocorticoid therapy for septic shock: a meta analysis
- 第三军医大学学报 2018年40卷第7期页码：636-642
- 作者机构：
  
  610041 成都，四川大学华西第二医院急诊科, 出生缺陷与相关妇儿疾病教育部重点实验室
- 作者简介：
  
  [李熙鸿，E-mail: hilixihong@163.com LI Xihong, E-mail:hilixihong@163.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201710157
  中图分类号： R181.23;R631.4;R977.11
- 收稿：2017-10-22，
  
  修回：2017-12-19，
  
  纸质出版：2018-04-15
- 稿件说明：
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高沪, 李熙鸿. 糖皮质激素对脓毒性休克的疗效及预后Meta分析[J]. 第三军医大学学报, 2018,40(7):636-642.

Hu GAO, Xihong LI. Efficacy and prognosis of glucocorticoid therapy for septic shock: a meta analysis[J]. Journal of Third Military Medical University, 2018, 40(7): 636-642.
高沪, 李熙鸿. 糖皮质激素对脓毒性休克的疗效及预后Meta分析[J]. 第三军医大学学报, 2018,40(7):636-642. DOI： 10.16016/j.1000-5404.201710157.

Hu GAO, Xihong LI. Efficacy and prognosis of glucocorticoid therapy for septic shock: a meta analysis[J]. Journal of Third Military Medical University, 2018, 40(7): 636-642. DOI： 10.16016/j.1000-5404.201710157.

摘要

目的

评价糖皮质激素在脓毒性休克治疗中的效果及对预后的影响。

方法

计算机检索Web of Science、PubMed、Embase、Cochrane Library、中国知网、万方、维普和中国生物医学文献数据库，收集有关糖皮质激素治疗脓毒性休克的临床研究，使用Jadad评分对纳入文献的质量进行评价，采用RevMan 5.3软件进行Meta分析。

结果

纳入7篇文献，共1 220例患者，Meta分析结果显示：糖皮质激素治疗组与对照组28 d病死率差异无统计学意义(

=1.09，95%

为0.85~1.39，

=0.51)，糖皮质激素治疗组高血糖并发症(

=0.59

95%

为0.41~0.83

=0.003)、出血并发症(

=0.64，95%

为0.44~0.95，

=0.03)显著高于对照组，但两组二重感染并发症差异无统计学意义(

=0.88，95%

为0.67~1.15，

=0.29)。

结论

采用糖皮质激素治疗不能降低脓毒性休克患者的病死率，可增加患者高血糖及出血并发症的发生率，但未增加二重感染的发生风险。

Abstract

Objective

To evaluate the efficacy and prognosis of glucocorticoid therapy in septic shock.

Methods

The databases including Web of Science

PubMed

Embase

Cochrane Library

CNKI

Wanfang

VIP database and Chinese Biomedical Database were searched for clinical trials concerning glucocorticoid therapy for septic shock. Jadad scale was used for methodological quality assessment of the included literatures. Software Revman 5.3 was used for meta analysis.

Results

Seven literatures containing a total of 1 220 cases were included for further analysis. The analysis showed that there was no statistical difference in 28-day mortality between the glucocorticoid therapy and control groups (

=1.09

95%

: 0.85~1.39

=0.51). But the incidence rates of hyperglycemia (

=0.59

95%

: 0.41~0.83

=0.003) and bleeding (

=0.64

95%

: 0.44~0.95

=0.03) were obviously higher in the former than the latter group. However

no statistical difference was seen in superinfection between the 2 groups (

=0.88

95%

: 0.6

7~1.15

=0.29).

Conclusion

Glucocorticoid therapy does not reduce the 28-day mortality in septic shock patients

but increases the incidences of hyperglycemia and hemorrhage

though it having no significant difference in the incidence of superinfection when compared with conventional treatment.

关键词

Keywords

references

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