摘要
目的系统评价特利加压素与奥曲肽在治疗食管胃底静脉曲张破裂出血中的区别,为临床提供合理的用药建议。方法检索7个中、英文数据库,纳入关于特利加压素与奥曲肽治疗食管胃底静脉曲张破裂出血的随机对照试验(RCT)。根据Cochrane偏倚风险评估工具对纳入的RCT进行质量评价,并采用RevMan5.3和StataSE12.0软件进行meta分析。结果纳入13篇RCT文献,包含食管胃底静脉曲张破裂出血患者1836例(特利加压素组917例,奥曲肽组919例)。在治疗食管胃底静脉曲张破裂出血方面,特利加压素与奥曲肽的出血控制率[相对危险度(RR)=1.00,95%可信区间(95%CI)0.92~1.09,Z=0.00,P=1.00)]、全因死亡率(RR=0.88,95%CI0.60~1.30,Z=0.63,P=0.53)、再出血率(RR=0.73,95%CI0.17~3.14,Z=0.42,P=0.68)、不良反应发生率(RR=0.69,95%CI0.31~1.52,Z=0.93,P=0.35)无显著差异。结论治疗食管胃底静脉曲张破裂出血特利加压素与奥曲肽具有同样的临床选择性,但奥曲肽更具经济选择优势。
Objective To systematically compare the efficacy and safety of terlipressin and octreotide for the patients with gastroesophageal variceal hemorrhage.Methods Seven Chinese and English databases were included in the randomized controlled trial(RCT)of teropressin and octreotide in the treatment of esophageal and gastric varicose hemorrhage.The quality of included RCT were evaluated by using the Cochrane risk of bias assessment tool.Then,meta-analysis was performed using RevMan 5.3 and Stata SE 12.0 software.Results Thirteen trials involving 1 836 patients were included(terlipressin group 917 patients;and octreotide group 919 patients).There were no significant differences in rates of control of bleeding[Relative risk(RR)=1.00,95%confidence interval(95%CI)0.92-1.09,Z=0.00,P=1.00)],mortality(RR=0.88,95%CI 0.60-1.30,Z=0.63,P=0.53),rebleeding(RR=0.73,95%CI 0.17-3.14,Z=0.42,P=0.68)and adverse events(RR=0.69,95%CI 0.31-1.52,Z=0.93,P=0.35).Conclusion Meta-analysis comparing terlipressin and octreotide failed to demonstrate a difference in the efficacy and safety,but octreotide favors over terlipressin in economics.
作者
张翔云
李宗尚
韩竞
焦伟杰
ZHANG Xiangyun;LI Zhongshang;HAN Jing;JIAO Weijie(Department of Pharmacy,Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou,Henan 450003,China;Department of Intensive Care Unit,Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou,Henan 450003,China)
出处
《现代医药卫生》
2019年第19期2968-2972,共5页
Journal of Modern Medicine & Health
