持续血液滤过联合血浆置换治疗HTG-AP临床效果的Meta分析

Meta analysis of the clinical effect of continuous hemofiltration combined with plasmapheresis in the treatment of HTG-AP

目的评价CVVH和PE治疗HTG-AP的有效性。方法搜索Cochrane Library、PubMed、web of science、embase、中文数据库、知网、万方、维普、中文数据库,搜索日期至2022年7月,获取CVVH+PE治疗HTG-AP的国内外有关医学文献可予以数据库搜索等检索方式;按照Cochrane Reviewer’s Handbook的规范,通过Stata16.0零软件和RevMan 5.0软件统计分析。结果收入了17篇论文,患者796例,CVVH+PE组409例,对照组392例。结果显示,CVVH+PE组总体治愈率明显提高:RR=1.33(1.22~1.45),且具有统计学意义Z=6.54,P=0.001<0.05,CVVH+PE的疗效显著优于单纯内科治疗,CVVH+PE是内科治疗的1.33倍。治疗后,TG效应量为-8.66(-9.66),且效应量显著(Z=-4.537,P<0.05),CVVH+PE组治疗后的TG比对照组显著低8.66。TNF-α效应量为-121.94,且效应量显著(Z=-2.662,P<0.05),CVVH+PE组治疗后的TNF-α比对照组显著低121.94。结论HTG-AP患者有效的治疗手段是CVVH+PE,目前需进一步开展大样本的RCT来评价CVVH+PE治疗HTG-AP的有效性和安全性。

Objective To evaluate the efficacy of CVVH and PE in the treatment of HTG-AP.Methods It searched Cochrane Library,PubMed and Web of Cochrane science,embase,Chinese database,CNKI,Waufang,VIP,Chinese database,search date up to July 2022,the relevant domestic and foreign medical literature CVVH+PE treatment of HTG-AP could be searched by database search and other retrieval methods;Statistical analysis was performed by Statal6.0 zero software and RevMan 5.0 software according to the specification of Cochrane Reviewer's Handbook.Results 17 papers and 796 patients were included,409 patients were in CWH+PE group and 392 were control group.The results showed that the overall cure rate of CVVH+PE group was significantly improved:RR=1.33(1.22-1.45),with statistical significance,Z=6.54,P=0.000001&lt;0.05,the efficacy of CVVH+PE was significantly better than the of medical treatment alone,and CVVH+PE was 1.33 times the of medical treatment After treatment,TG effect size was-8.66(-9.66),and the effect size was significance(Z=-4.537,P&lt;0.05),the TG of CVVH+PE group was 8.66 lower than that of control group after treatment The TNF-a effect size was-121.94 and significance(Z=-2.662,P&lt;0.05),the TNF-a in CWH+PE group was significantly lower than that in control group by 121.94.Conclusions CVVH+PE is an effective treatment for HTG-AP patients.At present,it is necessary to further carry out large sample RCTS to evaluate the efficacy and safety of CVVH+PE in the treatment of HTG-AP.