天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (10): 1108-1112.doi: 10.11958/20170716

• 循证医学 • 上一篇    下一篇

艾考糊精腹透液腹膜透析效果的 Meta 分析

卢志，魏芳△，姜埃利   

  1. 天津医科大学第二医院血液净化科（邮编 300211）
  • 收稿日期:2017-06-20 修回日期:2017-07-25 出版日期:2017-10-15 发布日期:2017-10-13
  • 通讯作者: 卢志 E-mail:luzhi2013@126.com
  • 作者简介:卢志（1988），男，硕士，住院医师，主要从事肾脏血液净化研究

The peritoneal dialysis efficacy of icodextrin-based solution: a Meta-analysis

LU Zhi，WEI Fang△，JIANG Ai-li   

  1. Department of Blood Purification, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
  • Received:2017-06-20 Revised:2017-07-25 Published:2017-10-15 Online:2017-10-13

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摘要： 目的 比较艾考糊精腹透液（ICO）与葡萄糖腹透液（GLU）在腹膜透析患者中的治疗效果。方法 2 位研 究者检索 Pubmed（1996—2016.12）、MEDLINE（1966—2016.12）、Embase（1974—2016.12）、Cochrane library 等期刊数 据库，独立对纳入的文献进行质量评价和数据提取，使用 RevMan 5.2 进行 Meta 分析。结果 10 项随机对照试验 （RCT）被纳入，共纳入患者 825 例，最终完成研究 661 例。Meta 分析结果显示：与对照组（GLU 组）相比，ICO 组在体 质量（WMD=-1.88，95%CI:-4.68～0.93，P=0.19）、空腹血糖（WMD=-0.76，95%CI:-1.79～0.28，P=0.15）、三酰甘油 （WMD=-0.56，95%CI:-1.18～0.06，P=0.08）、总胆固醇（WMD=-0.17，95%CI:-0.63～0.29，P=0.47）及不良事件发生率 （RR=1.06，95%CI:0.86～1.29，P=0.59）方面无差异，ICO 组在腹膜肌酐清除率（WMD=0.48，95%CI: 0.27～0.68，P＜ 0.001）及尿素清除率（WMD=0.44，95%CI: 0.23～0.66，P＜0.001）优于对照组。结论 艾考糊精腹透液能够提供更好 的腹膜肌酐和尿素清除率，且具有与葡萄糖腹透液相同的安全性。

关键词: 腹膜透析, Meta 分析, 艾考糊精腹透液, 葡萄糖腹透液, 腹膜肌酐清除率, 腹膜尿素清除率

Abstract: Objective To compare the efficacy of icodextrin-based solution (ico) and glucose-based solution (GLU) in peritoneal dialysis patients. Methods Pubmed (1996-2016.12), MEDLINE (1996-2016.12), Embase (1974-2016.12) and Cochrane library were searched by two independent investigators who conducted quality assessment and data mining and performed Meta-analysis using RevMan 5.2. Results Ten randomized controlled trials with 825 participants were included in this study, and 661 patients completed the trials at last. The Meta- analysis showed that there were no significant differences in body weight (WMD=-1.88, 95%CI:-4.68-0.93, P=0.19), fasting plasma glucose (WMD=-0.76, 95%CI:-1.79- 0.28, P=0.15), plasma triglycerides (WMD=-0.56, 95%CI:-1.18-0.06, P=0.08), plasma total cholesterol (WMD=-0.17, 95% CI:-0.63-0.29, P=0.47) and adverse events (RR=1.06, 95%CI:0.86-1.29, P=0.59) between ICO group and GLU group. The peritoneal creatinine clearance (WMD=0.48, 95%CI:0.27-0.68，P＜0.001) and peritoneal urea clearance (WMD=0.44, 95% CI:0.23- 0.66, P＜0.001) were better in ICO group than those of GLU group. Conclusion ICO can provide a better peritoneal creatinine clearance and peritoneal urea clearance, and which has the same safety compared with GLU.

Key words: peritoneal dialysis, Meta- analysis, icodextrin- based solution, glucose- based solution, peritoneal creatinine clearance, peritoneal urea clearance