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Received:May 25, 2023 Published Online:October 20, 2023
Received:May 25, 2023 Published Online:October 20, 2023
中文摘要: 目的 系统评价血必净注射液治疗脓毒症并发急性肾损伤(AKI)的效果,以期为该病的治疗提供临床用药循证参考。
方法 检索PubMed、Cochrane Library、Medline、中国知网、万方数据库、维普数据库,收集血必净注射液治疗脓毒症并发AKI的随机对照试验,检索时间为数据库建立至2023年4月20日。采用RevMan 5.3软件进行Meta分析,分析对象为血清血肌酐(Scr)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6水平,以及急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分和28 d病死率。采用漏斗图分析各项研究发表偏倚情况。结果 共纳入21篇文献1 781例患者。Meta分析显示,与对照组相比,血必净注射液治疗有助于患者Scr水平的改善(SMD=-1.01,95%CI:-1.41~-0.60,P<0.01)、TNF-α水平的下降(SMD=-2.61,95%CI:-3.58~-1.64,P<0.01)、IL-6水平的下降(SMD=-1.65,95%CI: -2.18~-1.12,P<0.01)、APACHE Ⅱ评分的降低(SMD=-2.41,95%CI: -3.42~-1.40,P<0.01)和28 d病死率的降低(RR=0.81,95%CI: 0.68~0.96,P<0.01)。
结论 血必净注射液有较好的抗炎、改善肾功能的效果,其与常规治疗联合应用,可以提高脓毒症并发AKI的疗效。
Abstract:ObjectiveTo systematically evaluate the efficacy of Xuebijing Injection in the treatment of sepsis complicated with acute kidney injury(AKI), in order to provide a evidence-based reference for the treatment of this disease.
Methods PubMed, Cochrane Library, Medline, CNKI, Wanfang Database, and VIP Database were used to search and collect randomized controlled trials(RCTs) of Xuebijing Injection in the treatment of sepsis complicated with AKI. The search was conducted until April 20, 2023. Meta-analysis was performed using RevMan 5.3 software, with analysis subjects including serum creatinine (Scr), tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels, as well as APACHEⅡ score and 28-day mortality. The funnel diagram was used to analyze the publication bias of various studies.
Results A total of 21 articles including 1 781 patients were included. Meta-analysis showed that compared with the control group, Xuebijing Injection helped improvement in patient's Scr (SMD=-1.01,95%CI:-1.41 to -0.60, P<0.01), decrease in TNF- α (SMD=-2.61,95%CI:-3.58 to -1.64, P<0.01), decrease in IL-6 (SMD=-1.65,95%CI:-2.18 to -1.12, P<0.01), decrease in APACHE Ⅱ score(SMD=-2.41,95%CI:-3.42 to -1.40, P<0.01), and decrease in 28-day mortality (RR=0.81, 95%CI: 0.68 to 0.96, P<0.01). Conclusion Xuebijing Injection has good effects of anti-inflammatory and renal function improvement, and its combination with conventional treatment can improve the efficacy of sepsis complicated with AKI.
keywords: Xuebijing Injection Sepsis Acute kidney injury Meta-analysis Serum creatinine Tumor necrosis factor-α Interleukin-6
文章编号: 中图分类号:R459.7 文献标志码:A
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