天津医药

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连续性肾脏替代治疗对重度急性胰腺炎疗效的meta分析

王喆   

  1. 天津医科大学第二医院
  • 收稿日期:2013-12-05 修回日期:2014-03-26 出版日期:2014-08-15 发布日期:2014-08-15
  • 通讯作者: 王喆

Meta-Analysis of Effect of Continuous Renal Replacement Therapy to Severe Acute Pancreatitis

zhe Wang   

  1. The Second Hospital of Tianjin Medical University, Tianjin300211, China
  • Received:2013-12-05 Revised:2014-03-26 Published:2014-08-15 Online:2014-08-15
  • Contact: zhe Wang

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摘要：

【摘要】目的  评价连续性肾脏替代治疗(CRRT)对重度急性胰腺炎(SAP)患者的治疗效果。方法  计算机检索MEDLINE（1966—2013.9）、Embase (1974—2013.9)、中文万方数据库（1996—2013.9）、CNKI（1979—2013.9）、Cochrane图书馆临床对照试验资料库。手工检索已发表或未发表的相关文献，包括会议摘要等。由2名评价员独立对纳入的文献进行质量评价和数据提取，用RevMan5.2软件进行Meta分析。结果  共纳入15项随机对照试验，共计652例患者。Meta分析结果显示CRRT治疗与传统治疗方法比较，可以明显降低血淀粉酶水平（WMD=-140.76，95%CI为-212.42～-69.11，P=0.0001），清除炎症介质，降低APACHEⅡ评分(WMD=-2.97，95%CI-4.01～-1.93，P<0.001)，有效提高存活率(RR=1.35，95%CI1.19～1.52，P<0.001)。结论  CRRT治疗可有效提高SAP患者的存活率。

关键词: 胰腺炎, 肾替代疗法, 预后, Meta分析, 淀粉酶类, C反应蛋白质, 重度急性胰腺炎, 连续性肾脏替代治疗

Abstract: [Abstract]  Objective   To assess the effect of continuous renal replacement therapy (CRRT) on severe acute pancreatitis (SAP)．Methods   According to the collaborative search strategy，MEDLINE(1966-2013.9), OVID(1963-2013.9), Chinese Wanfang database(1996-2013.9）,CNKI（1979-2013.9）, the clinical control test database of Cochrane Library and were searched．Related literature，whether Published or not and meeting summary included，were searched by hand．Quality assessment and data extraction were conducted by two independent investigators．Meta-analysis was conducted by RevMan 5.0.Results   A total of 15 reports were identified which met the inclusion criteria，including 652 patients．Compared with control group ,the serum amylase decreased in CRRT group [WMD =-140.76，95%CI（-212.42～-69.11），P=0.0001], inflammatory mediators removed effectively and APACHEⅡ score also decreased in CRRT group [WMD=-3.09，95%CI（-4.37～-1.45，P=0.0002]. The overall survival rate was significantly higher in CRRT group than that in control group[RR=1.35，95%CI（1.19～1.52），P<0.00001].Conclusion   Continuous renal replacement therapy could effectively improve the prognosis of patients with severe acute pancreatitis.

Key words: pancreatitis, renal replacement therapy, prognosis, Meta-analysis, amylases, C-reactive protein, severe acute pancreatitis, 连续性肾脏替代治疗