多烯磷脂酰胆碱注射液用于治疗非酒精性脂肪性肝病的疗效和安全性Meta分析

Meta analysis of the efficacy and safety of polyene phosphatidylcholine injection in the treatment of non-alcoholic fatty liver disease

目的系统评估多烯磷脂酰胆碱(PPC)注射液用于治疗非酒精性脂肪性肝病(NAFLD)的疗效和安全性评价。方法检索PubMed、EmBase、The Cochrane Library、中国知网、中国生物医学文摘数据库、维普数据库和万方数据库,纳入多烯磷脂酰胆碱注射液用于治疗NAFLD的随机对照临床试验,检索时限均为建库至2021年1月。试验组给予多烯磷脂酰胆碱注射液处置,对照组给予另一种护肝药物处置。用Stata 12.0软件对总有效率和肝功能及血脂相关指标进行荟萃分析。结果最终纳入文献8篇,共696例NAFLD患者。Meta分析结果表明:多烯磷脂酰胆碱注射液用于治疗NAFLD在总有效率方面显著优于对照组[风险比(RR)=1.36,95%CI=1.21~1.53,P<0.01],同时能显著改善谷丙转氨酶[加权均数差值(WMD)=-15.01,95%CI=-23.13~-6.90,P<0.01]、谷草转氨酶[WMD=-12.53,95%CI=-18.72~-6.33,P<0.01]、总胆红素[WMD=-9.81,95%CI=-16.43~-3.19,P<0.01]、谷氨酰转肽酶[WMD=-37.19,95%CI=-71.85~-2.53,P<0.05]、总胆固醇[WMD=-0.65,95%CI=-1.20~-0.09,P<0.05]和三酰甘油[WMD=-2.16,95%CI=-3.22~-1.10,P<0.01]。此外,没有文献报道与PPC注射液相关的明显药物不良反应。结论PPC注射液能有效治疗NAFLD,且无明显药物不良反应。

Objective To investigate the efficacy and safety of polyene phosphatidylcholine(PPC)injection in the treatment of non-alcoholic fatty liver disease(NAFLD).Methods We searched PubMed,EMbase,The Cochrane Library,CNKI,China biomedical abstracts database,VIP database and Wanfang database for retrieving randomized controlled clinical trials(RCT)about PPC injection for the treatment of (NAFL)before January 2021.The experimental group was treated with polyene phosphatidylcholine injection,and the control group was treated with other liver-protecting drugs.Using stata 12.0 software to conduct a meta-analysis of the main indicators of treatment total effective rate and liver function related indicators.Results Eight RCTs were included finally having 696 patients with NAFLD.Meta-analysis results showed that PPC injection for the treatment of NFALD was superior to that in control group in terms of total effective rate[relative risk(RR)=1.36,95%CI=1.21-1.53,P<0.01],and could also significantly improve the indicators of glutamic-pyruvic transaminase[weighted mean difference(WMD)=-15.01,95%CI=-23.13--6.90,P<0.01],glutamic-oxaloacetic transaminase(WMD=-12.53,95%CI=-18.72--6.33,P<0.01),total bilirubin(WMD=-9.81,95%CI=-16.43--3.19,P<0.01)glutamyl transpeptidase(WMD=-37.19,95%CI=-71.85--2.53,P<0.05),total cholesterol(WMD=-0.65,95%CI=-1.20--0.09,P<0.05)and triglycerides(WMD=-2.16,95%CI=-3.22--1.10,P<0.01).In addition,no obvious adverse drug reactions related to PPC injection have been reported.Conclusion PPC injection could effectively treat NAFLD without obvious adverse drug reactions.