卡维地洛与普萘洛尔对肝硬化门静脉高压症疗效比较的Meta分析

摘要/Abstract

摘要： 目的比较卡维地洛与普萘洛尔在肝硬化患者中降低肝静脉压力梯度(hepatic venous pressure gradient,HVPG)以及平均动脉压(mean arterial pressure,MAP)的疗效及药物安全性。方法检索国内外主要文献数据库 PubMed、Cochrane library、中国生物医学文献数据库(SinoMed) 、中国知网(CNKI)、万方数据库、维普中文科技期刊数据库等,从建库至2016年12月针对卡维地洛和普萘洛尔降低肝硬化门静脉高压的临床研究。纳入的文献经Cochrane偏倚风险评价表进行评价。Review Manager 5.3软件对纳入的研究数据进行Meta分析,分别计算比值比(odds ratio,OR)和均数差(mean difference,MD)以及各自的95％可信区间(95％ CI),同时进行I²检验评价Meta分析结果的异质性,通过敏感性分析异质性的来源。结果该研究共纳入16篇文献,累计患者1137例,其中卡维地洛组582例,普萘洛尔组555例。结果显示卡维地洛比普萘洛尔具有更好的HVPG下降率(P＜0.05)和MAP下降率(P＜0.05),同时卡维地洛比普萘洛尔对心率(heart rate,HR)及心输出量(cardiac output,CO)的影响较小(P＜0.05)。结论在降低肝硬化患者门静脉高压中卡维地洛比普萘洛尔具有更佳的疗效和安全性。

关键词: 卡维地洛, 普萘洛尔, 肝硬化, 门静脉高压

李盼, 朱萱, 李弼民, 郭贵海, 王健, 汪安江, 游宇. 卡维地洛与普萘洛尔对肝硬化门静脉高压症疗效比较的Meta分析[J]. 肝脏, 2018, 23(6): 508-514.

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