低分子肝素对慢性阻塞性肺疾病急性加重治疗效果的Meta分析

Effects of low molecular weight heparin on patients with AECOPD: a meta-analysis

目的系统评价低分子肝素(LMWH)治疗慢性阻塞性肺疾病急性加重(AECOPD)的疗效。方法计算机检索文献,查找采用LMWH+常规治疗与单纯常规治疗比较AECOPD疗效的随机对照试验。按照纳入排除标准筛查文献,提取资料,进行质量评价,采用Rev Man 5.2软件进行Meta分析。结果共纳入12个随机对照试验(RCT),共计879例患者。Meta分析结果显示:1与对照组相比,LMWH可改善AECOPD患者的动脉血氧分压、二氧化碳分压。2LMWH治疗组对于患者肺功能FEV1和红细胞压积的改善,与对照组差异无统计学意义。结论与对照组相比,LMWH治疗组不能改善AECOPD患者FEV1和红细胞压积指标,但能有效改善动脉血氧分压及二氧化碳分压。

Objective To estimate the effect of low molecular weight heparin （LMWH） combined with conventional treatment on patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods Literature on randomized control trials（RCTs） with AECOPD treated by LMWH combined with conventional methods was collected in PubMed. The studies were selected according to inclusive and exclusive criteria. The data were extracted, the quality was assessed, and meta-analysis was conducted with RevMan 5.2 software. Results There were twelve RCTs including 879 patients with AECOPD in the current study. The results of mcta-analysis showed that：（1）LMWH could obviously improve PaO2 and PaCO2 of patients with AECOPD as compared with the control group. （2）There was no statistically significant difference between the LMWH-treated group and control group in the improvement of FEV, or hematocrit. Conclusion LMWH can significantly improve arterial blood gas analysis in AECOPD, but does not improve FEV1 or hematocrit.