乌司他丁治疗急性呼吸窘迫综合征效果的荟萃分析

Effect of ulinastatin on acute respiratory distress syndrome:A meta-analysis

目的系统评价乌司他丁治疗急性呼吸窘迫综合征的效果。方法检索2012年5月以前在PubMed、Embase、CBMdisk、CNKI和万方数据库公开发表的有关乌司他丁治疗急性呼吸窘迫综合征的临床研究并采用Cochrane协作网提供的ReviewManager4.2软件对纳入的研究做Meta分析。疗效判定指标包括呼吸频率、氧合指数、PaCO2以及病死率。结果 Meta分析显示,经过7 d的治疗,乌司他丁治疗组的呼吸频率均数小于对照组(WMD=-5.74,P=0.003),而且前者的PaCO2均数(WMD=4.78,P<0.000 01)、氧合指数均数(WMD=59.94,P<0.000 01)都高于对照组;此外,乌司他丁治疗组的病死率低于对照组(RR=0.62,P=0.04)。结论乌司他丁在改善肺通气和降低急性呼吸窘迫综合征的病死率方面优势明显。

Objective To assess the effect of ulinastatin on acute respiratory distress syndrome（ARDS）.Methods A meta-analysis was performed for the clinical trials on ulinastatin in treatment of ARDS covered in PubMed,Embase,CBMdisk,CNKI and Wanfang Database before May 2012 with the software of ReviewManager4.2 on Cochrane Cooperation Network.The curative effect indexes of ulinastatin included respiratory frequency,PaO2/FiO2,PaCO2and mortality.Results Meta analysis showed that the mean respiratory frequency and mortality were lower whereas the mean PaCO2 and PaO2/FiO2 were higher in ulinastatin treatment group than in control group 7 days after ulinastatin treatment（WMD=-5.74,P=0.003;RR=0.62,P=0.04;WMD=4.78,P 〈0.000 01;WMD=59.94,P 〈0.000 01）.Conclusion Ulinastatin can significantly improve the pulmonary ventilation and reduce the mortality of ARDS patients.