国内人工肝支持系统治疗重型肝炎疗效的Meta分析

The efficacy of artificial liver support system treatment on hepatic failure in China:a meta-analysis

目的探讨国内应用人工肝支持系统治疗重型肝炎的疗效。方法检索国内1990-2005年公开发表的人工肝治疗重型肝炎相关论文及会议论文,提取其中的生存率或出院时临床好转率等可以反映远期预后的资料,以比值比(OR)为效应量进行异质性检验和统计量合并分析。结果入选的10项研究中,共包含重型肝炎患者1030例,对照组均给予常规内科治疗,治疗组均为常规内科治疗联台人工肝治疗。早期、中期、晚期治疗组和对照组比较,其合并OR值(95%可信区间)分别为3．72(2．03-6．83)、2．79(2．88～4．14)和1．85(0．96～3．56)。结论和常规内科治疗相比,人工肝支持系统可显著改善早期及中期重型肝炎患者的远期预后,而对晚期重型肝炎患者远期预后无明显改善。

Objective Conducting a meta-analysis to evaluate the efficacy of artificial liver support system （ALSS） in the treatment of hepatic failure in China. Methods Clinical trials comparing ALSS vs. routine medical treatment of hepatic failure in China were identified from computer-based literature. The pooled odds ratio and 95% confidence interval （CI） of prognostic indicators, such as survival rate and clinical improvement rate at discharge, were used to measure the magnitude of the efficacy. Results Ten trials including 1030 patients were identified. The odds ratio （95% CI） of survivorship or improvement of ALSS over routine medical treatment in early, intermediate and advanced stages of hepatic failure were 3.72 （2.03-6.83）, 2.79 （2.88-4.14） and 1.85 （0.96-3.56） respectively. Conclusion ALSS treatment is more effective in early and intermediate stages of hepatic failure than routine medical treatment, but not in its advanced stage.