奥曲肽与垂体后叶素治疗肝硬化并上消化道出血临床疗效比较的Meta分析

Comparion of octreotide and vasopressin in treatment of liver cirrhosis with upper gastrointestinal bleeding:A meta-analysis

目的系统性评价比较奥曲肽与垂体后叶素治疗肝硬化并上消化道出血的疗效。方法系统检索PubMed、Cochrane Library、Web of Science数据库,检索以奥曲肽或垂体后叶素治疗肝硬化并上消化道出血的随机对照试验,检索时限均从建库起截至2016年7月。由两位研究者按照纳入与排除标准独立筛选文献、提取资料并评价质量后,采用RevMan5.2软件进行Meta分析。结果最终纳入6个随机对照试验,共635例患者,其中奥曲肽组(观察组)321例,垂体后叶素组(对照组)314例。Meta分析结果显示,观察组的初始止血率相较于对照组有所增加,差异有统计学意义;观察组的再出血率、病死率、不良反应发生率与对照组相比较,差异均无统计学意义。结论与垂体后叶素相比较,奥曲肽的止血率较高,但两者在降低再出血率、病死率以及不良反应发生率方面的差异并无统计学意义。

Objective An attempt was made in this paper to systemically compare the efficacy of vasopressin and octreotide for the treatment of liver cirrhosis with upper gastrointestinal bleeding.Methods Literature on the efficacy of octreotide versus vasopressin for the treatment of liver cirrhosis upper gastrointestinal bleeding were retrieved in PubMed,the Cochrane Library,and the Web of Science from the inception to July 2016.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted the data,and assessed the risk of bias of included studies.Then,a meta-analysis was performed by using RevMan5.2.Results A total of 6 RCTs involving635 patients were included,of which,321 cases were in the octreotide group and 314 cases in the vasopressin group.The results of the meta-analysis showed that the efficacy of the observation group was superior to that of the control group in initial hemostasis rate,with a significant difference.However,there were no significant difference in recurrent bleeding rate,mortality,and adverse effects rate between the observation group and the control group.Conclusions Compared to vasopressin,octreotide can effectively increase the initial hemostasis rate in patients with liver cirrhosis accompanied upper gastrointestinal bleeding.However,there are no significant difference in recurrent bleeding rate,mortality,and adverse effects rate between vasopressin and octreotide.