重组人红细胞生成素治疗老年髋部骨折围术期贫血效果研究的Meta分析

Meta analysis of the research on the effect of recombinant human erythropoietin on perioperative hemorrhagic anemia in senile hip fracture

目的系统评价重组人红细胞生成素(Recombinant human erythropoietin,rhEPO)对老年髋部骨折围术期失血性贫血的治疗效果。方法通过检索重组人红细胞生成素(rhEPO)治疗老年髋部骨折围术期失血性贫血的临床研究文献,收集符合要求的随机对照试验(Randomized controlled trial,RCT)文献,运用Cochrane系统评价的方法,使用Revmen5.3软件进行Meta分析。结果共纳入4篇文献,总计307例老年髋部骨折术后病例,结果显示,重组人红细胞生成素治疗老年髋部骨折围手术期失血性贫血术后输血率较对照组低[总输血率:OR=0.47,95%CI(0.26,0.83),Z=2.59,P=0.01],血红蛋白(Hemoglobin,Hb)、红细胞压积(Hematocrit,Hct)均高于对照组[血红蛋白:OR=7.74,95%CI(3.86,11.61),Z=3.91,P<0.0001;红细胞压积:OR=2.95,95%CI(0.69,5.22),Z=2.55,P=0.01],差异有统计学意义。结论重组人红细胞生成素(rhEPO)治疗老年髋部骨折围术期失血性贫血有效。

Objective To systematically evaluate the therapeutic effect of recombinant human erythropoietin(rhEPO)on perioperative hemorrhagic anemia in senile hip fracture.Methods By searching clinical research literatures of rhEPO in the treatment of perioperative hemorrhagic anemia in senile hip fracture,the literatures of randomized controlled trial(RCT)which meets the requirements were collected,and Meta-analyzed by Cochrane systematic evaluation method and Revmen5.3 software.Results A total of 4 papers covering 307 postoperative cases of senile hip fracture were included.The results showed that the postoperative blood transfusion rate of the cases of perioperative hemorrhagic anemia in senile hip fracture treated by rhEPO was lower than that of the control group(total blood transfusion rate:OR=0.47,95%CI[0.26,0.83],Z=2.59,P=0.01),and the hemoglobin(Hb)and the hematocrit(Hct)were both superior to those of the control group(Hb:OR=7.74,95%CI[3.86,11.61],Z=3.91,P<0.0001;Hct:OR=2.95,95%CI[0.69,5.22],Z=2.55,P=0.01),with statistically significant differences.Conclusion RhEPO is effective in the treatment of perioperative hemorrhagic anemia in senile hip fracture.