恩替卡韦治疗乙肝病毒重型肝炎肝衰竭的随机对照试验的Meta分析

Effect of entecavir on reducing mortality of HBV-related liver failure:a meta-analysis

目的系统评价恩替卡韦（entecavir，ETV）治疗乙型肝炎病毒（HBV）相关性肝衰竭（重型肝炎）的效果。方法检索2005—01至2010—03在PubMed、Ovid、SpringLink、BiosisPreviews、AcademicResearchPremier（ASP）、Cochrane和CNKI、VIP、CBM收录的有关内科常规治疗基础上加用ETV抗病毒对HBV相关性肝衰竭／重型肝炎患者病死率影响的随机对照试验（RCT），2名研究者独立采用Jadad评分对全部纳入文献进行质量评价，异质性分析使用∥检验，以比值比（OR）为效应量进行Meta分析。结果共纳入5篇RCT，病死率合并效应量（OR）为0．25，95％可信区间（95％CI）为0．15～0．41，P〈0．01。结论与内科常规治疗相比，加用ETV抗病毒可以显著降低HBV相关性肝衰竭（重型肝炎）患者的病死率。

Objective To evaluate the effect of entecavir on reducing mortality of HBV - related liver failure. Methods Pubmed, Ovid, Spring Link, Biosis Previews, Academic Research Premier, the Cochrane library and CBM,VIP,CNKI were searched from January 2005 to March 2010. Randomized controlled trials comparing entecavir with routine medical treatment for liver failure were eligible for inclusion. Relevant literature that dealt with mortality was chosen. Two investigators independently assessed the quality and extracted the data. Heterogeneity was examined by chi - square test. Odds ratio （OR） was used to evaluate the effect of enteeavir on improving case fatality. Results Only five RCTS were included. OR was 0.25 （ 95 % CI ： 0.15 - 0.41 ） ,P 〈 0.01. Conclusions Combination with entecavir is more effective than routine medical treatment alone in reducing the mortality of HBV - related liver failure.