低分子肝素治疗脓毒症临床疗效的Meta分析

A Meta-analysis of the clinical effects of low molecular weight heparin on sepsis

目的系统评价低分子肝素对脓毒症的治疗效果。方法检索Pubmed、Medline、中国科技期刊数据库等数据库中1995年1月至2013年3月公开发表的有关应用低分子肝素对脓毒症疗效的随机对照临床试验研究,对符合纳入标准文献的APACHEⅡ和凝血指标,以及28天病死率进行Meta分析。结果共有8篇文献,包括449例脓毒症患者纳入研究。Meta分析显示,相对于对照组,低分子肝素治疗组的APACHE II评分、血小板计数和D-二聚体水平显著改善,同时显著降低28天病死率(均P<0.05)。结论低分子肝素可一定程度上改善脓毒症患者的凝血功能,具有一定的安全性和较好的预后。

Objective To evaluate the clinical efficacy of low molecular weight heparin in the treatment of sepsis. Method Data of comparative studies conducted during the period from 1995 to 2013 of Low Molecular Weight Heparin（ LMWP） and regular treatment for sepsis were first retrieved from Pubmed,Medline,Cochrane Library,CNKI and Chinese Biomedical Database. A Meta-analysis was then conducted to examine the APACHE II score,the characteristics of coagulation,and the incidence rate of 28-d mortality included in the literature retrieved by RevMan 5. 0 software. Findings The literature of a total of 8 studies was reviewed,which included 449 cases of patients with sepsis. The analysis showed that compared with regular treatment,LMWP treatment could improve significantly the APACHE II scores,PLT and DDimer level,and significantly decline the mortality rate of 28 days（ P 0. 05）. Conclusion LMWP can improve the coagulation of patients of sepsis,leading a safe and better prognosis.