糖皮质激素治疗重型病毒性肝炎有效性的系统评价
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Efficacy of glucocorticoids on severe viral hepatitis:a systematic review
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    目的:评价糖皮质激素治疗重型病毒性肝炎的有效性-方法:计算机检索PubMed-EMbase-Science Direct-万方-维普-中国生物医学文献数据库,检索时限为1995~2010年,最后检索日期为:2010年10月10日-在严格质量评价的基础上,使用RevMan5软件进行系统评价-结果:初检出683篇文献,经筛选最终纳入12篇文献进行分析-Meta分析结果显示:①死亡率:激素组与对照组相比,有明显统计学差异,激素组死亡率减少达36%(RR=0.64,95%CI:0.42~0.98,P = 0.04)-②有效率:激素组与对照组相比,有明显统计学差异,激素组有效率增加达63%(RR=1.63,95%CI:1.35~1.98,P < 0.000 01)-结论:本系统评价显示使用糖皮质激素治疗重型病毒性肝炎与不使用相比,具有降低死亡率,改善肝功能的趋势-但由于本系统评价纳入的文献质量有限,有必要开展更多设计严谨,大样本-多中心的随机对照试验来确证-

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    Objective: To assess the efficacy of glucocorticoids on the treatment of severe viral hepatitis. Methods: A comprehensive search for articles from 1995 to 2010 was conducted from databases including PubMed,EMbase,Science Direct,Wanfang,VIP,and CBM. The last search was performed on 10th October 2010. The quality of included studies was critically evaluated. Data were analysed using the Cochrane Collaboration’s RevMan 5 software. Results: A total of 683 articles were retrieved,but only 12 were finally included. Compare with the control group,meta-analyses showed that the mortality in glucocorticoids group reduced by 36%(RR=0.64,95%CI=0.42~0.98,P = 0.04),the effective rate in glucocorticoids group increased by 63% (RR=1.63,95%CI=1.35~1.98,P < 0.01). Both of them have significant differences. Conclusion: Compared with the control group,glucocorticoids tends to reduce mortality and improve liver function. However,it is necessary to do more well-desinged multi-center large-scale randomized controlled trials to confirm this.

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杨 潇,钱 婧,钱佳萍,翁亚丽.糖皮质激素治疗重型病毒性肝炎有效性的系统评价[J].南京医科大学学报(自然科学版),2011,(10):1476-1482

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  • 收稿日期:2011-02-23
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