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[摘要]
目的 系统评价泮托拉唑对比H2受体拮抗剂预防术后应激性溃疡的有效性和安全性,为临床提供循证参考。方法 计算机检索PubMed、EmBase、Cochrane Library、Clinicaltrials.gov、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)和万方数据库,收集泮托拉唑(试验组)对比H2受体拮抗剂(对照组)预防术后应激性溃疡的临床随机对照试验(RCT),提取资料后,采用Rev Man 5.3统计软件进行Meta-分析。结果 共纳入14项RCT,共计1 066例患者。Meta-分析结果显示:与对照组相比,试验组应激性溃疡出血(SUB)率显著降低,差异有统计学意义[OR=0.15,95% CI(0.10,0.23),P<0.000 01];试验组不良反应发生率低于对照组,差异有统计学意义[OR=0.12,95% CI(0.03,0.53),P=0.005]。亚组分析显示术前给药的研究SUB发生率(OR=0.12)低于术后给药的(OR=0.21);预防疗程≤ 7 d的研究SUB发生率(OR=0.15)与疗程>7 d的(OR=0.14)相当。结论 与H2受体拮抗剂相比,泮托拉唑在预防术后应激性溃疡时能显著降低应激性溃疡出血率,且不良反应发生率更低。
[Key word]
[Abstract]
Objective To evaluate effectiveness and safety of pantoprazole versus H2 receptor antagonist for the prevention of postoperative stress ulce, and to provide evidence-based reference in clinic. Methods Retrieved from PubMed, EmBase, Cochrane Library, Clinicaltrials.gov, CNKI, Wanfang datebase and CBM, randomized controlled trials (RCT) about pantoprazole (trial group) versus H2 receptor antagonist (control group) for the prevention of postoperative stress ulce were collected. Meta-analysis was conducted by RevMan 5.3 software after data extraction. Results A total of 14 RCT were inclued, involving 1 106 patients. Metaanalysis showed, the incidences of SUB[OR=0.15, 95% CI(0.10, 0.23), P<0.000 01] and the incidences of ADR[OR=0.12, 95% CI (0.03, 0.53), P=0.005] in trial group were significantly lower than control group, with statistical significance. Results of subgroup analysis showed, the incidences of SUB in preoperative adminiatration (OR=0.12) was lower than postoperative adminiatration (OR=0.21). The incidences of SUB between the course of less than 7 days (contain 7days) (OR=0.15) and more than 7 days (OR=0.14) were similar. Conclusion s The incidences of SUB and ADR of pantoprazole were significantly lower than that of H2 receptor antagonist for the prevention of postoperative stress ulce.
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[基金项目]
河北省医学科学研究重点课题计划(20181292)