高脂低糖膳食对慢性阻塞性肺疾病机械通气患者呼吸功能状况影响的meta分析

Meta-analysis of the effect of high-fat and low-sugar diet on respiratory function in patients with mechanical ventilation of COPD

目的系统评价高脂低糖膳食对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)机械通气患者呼吸功能状况的影响。方法计算机检索中国知网(CNKI)、维普数据库(VIP)、万方数据库、PubMed、EMbase等中英文数据库。搜集2019年10月前发表的有关高脂低糖膳食和COPD机械通气的中英文随机对照试验(RCTs),检索时间自2009年1月至2019年10月。由2位研究员分别独立的筛选符合纳入和排除标准的文献后汇总意见并提取资料,采用Cochrane偏倚风险评估工具对文献质量进行评价。结果共纳入15个RCTs,包括1146例患者。Meta分析结果显示,COPD机械通气患者每分钟通气量(VE)[MD=-1.4,Z=8.23,P<0.01,95%CI-1.74,-1.07),每分钟二氧化碳产生量(VCO2)(MD=-42.61,Z=8.65,P<0.01,95%CI-52.26,-32.96),每分钟耗氧量(VO2)(MD=-30.16,Z=7.37,P<0.01,95%CI-38.18,-22.14),呼吸商(RQ)(MD=-0.08,Z=19.3,P<0.01,95%CI-0.08,-0.07),动脉血二氧化碳分压(PaCO2)(MD=-1.13,Z=5.93,P<0.01,95%CI-1.5,-0.76),动脉氧分压(PaO2)(MD=1.24,Z=8.02,P<0.01,95%CI 0.94,1.54),应用高脂低糖组均优于对照组。结论高脂低糖膳食有助于改善COPD机械通气患者的通气状况,减少CO2的产生,降低PaCO2,提高PaO2,纠正呼吸衰竭。

Objective To systematically evaluate the effects of high-fat and low-sugar diet on respiratory function in patients with mechanical ventilation of chronic obstructive pulmonary disease(COPD).Methods Chinese and English databases,such as China national knowledge infrastructure(CNKI),VIP database(VIP),Wanfang database,PubMed,EMbase were searched.Randomized controlled trials(RCTs)in Chinese and English on high-fat and low-sugar diet and COPD mechanical ventilation published in 2019 were collected from January to October.Two researchers independently screened the literature that met the inclusion and exclusion criteria,summarized the opinions and extracted the data.The Cochrane bias risk assessment tool was used to evaluate the quality of the literature.Results A total of 15 RCTs were collected,including 1146 patients.Meta-analysis showed the data of high-fat and low-sugar group were higher than those of control group in many aspects,such as VE(MD=-1.4,Z=8.23,P<0.01,95%CI-1.74,-1.07),VCO 2(MD=-42.61,Z=8.65,P<0.01,95%CI-52.26,-32.96),VO 2(MD=-30.16,Z=7.37,P<0.01,95%CI-38.18,-22.14),RQ(MD=-0.08,Z=19.3,P<0.01,95%CI-0.08,-0.07),PaCO 2(MD=-1.13,Z=5.93,P<0.01,95%CI-1.5,-0.76),PaO 2(MD=1.24,Z=8.02,P<0.01,95%CI 0.94,1.54).Conclusion High-fat and low-sugar diets can improve respiratory function in patients with COPD mechanical ventilation,reduce the production of CO,lower PaCO 2,raise PaO 2,and correct respiratory failure.