饮食教育对血液透析患者高磷血症干预效果的Meta分析

Effectiveness of health education on dietary among hemodialysis patients with hyperphosphatemia: a meta-analysis

目的定量评价饮食教育对血液透析患者高磷血症的疗效性。方法计算机检索2000年1月—2015年9月国内外饮食教育对血液透析伴高磷血症患者影响的随机对照试验(RCT)文献。对符合条件研究中的血磷、血钙、钙磷乘积指标采用Rev Man 5.3软件进行分析。结果共纳入12篇符合要求的RCT研究,包括血液透析伴高磷血症患者964例。Meta分析结果显示,饮食教育对血液透析伴高磷血症患者血磷、钙磷乘积有统计学差异[WMD=-0.26,95%CI(-0.32,-0.21),P<0.00001;WMD=-0.66,95%CI(-0.82,-0.49),P<0.00001],饮食教育对血液透析伴高磷血症患者血钙无统计学差异[WMD=0.03,95%CI(-0.02,0.07),P=0.24]。结论饮食教育能降低血液透析伴高磷血症患者的血磷、钙磷乘积水平,对血钙水平无影响。

Objective To evaluate the effectiveness of dietary education for hemodialysis patients with hyperphosphatemia. Methods The articles at home and abroad, which includeing dietary education for hemodialysis patients with hyperphosphatemia by original randomized controlled trials （RCT） between January 2000 and January 2015, were enrolled in this review and the eligible studies, such as serum calcium, phosphorus and calcium-phosphorus product, were analyzed by using RevMan 5.3 software. Results This review contains 12 RCT studies, including 961 hemodialysis patients with hyperphosphatemia. The Meta analysis results showed that dietary education for hemodialysis patients with hyperphosphatemia were significant differences in the serum phosphorus, calcium-phosphate product [ WMD = - 0. 26, 95% CI （ - 0. 32, -0.21）, P〈0.00001; WMD = -0.66, 95%CI （ -0.82, -0.49）, P〈0.00001], but these is no significant differences in the calcium [ WMD = 0. 03, 95% CI （ - 0. 02, 0. 07）, P = 0. 24]. Conclusion Dietary education can reduce the levels of serum phosphorus, calcium and phosphorus product in hemodialysis patients with hyperphosphatemia, but blood calcium levels had no effect.