肝脏 ›› 2020, Vol. 25 ›› Issue (8): 863-866.

• 其他肝病 • 上一篇    下一篇

粒细胞集落刺激因子治疗肝衰竭有效性及安全性的meta分析

于淙, 周培   

  1. 264400 山东 威海市中心医院感染性疾病科
  • 收稿日期:2019-05-03 出版日期:2020-08-31 发布日期:2020-09-04
  • 通讯作者: 周培:Email:445631134@qq.com

Efficacy and safety of granulocyte colony-stimulating factor in treatment of patients with hepatic failure: A Meta-analysis

YU Cong, ZHOU Pei   

  1. Department of Infectious Diseases, Weihai Central Hospital, Weihai, 264400, China
  • Received:2019-05-03 Online:2020-08-31 Published:2020-09-04
  • Contact: ZHOU Pei, E-mail: 445631134@qq.com

摘要: 目的 对粒细胞集落刺激因子(G-CSF)治疗肝衰竭是否有效及安全进行系统评价。方法 电子检索截至2018年1月之前公开发表在PubMed、万方数据库、Cochrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(VIP)的随机对照试验。随机临床实验包括对比使用任何方案的G-CSF与安慰剂或没有干预的肝衰竭患者。主要结局包括总死亡率、器官衰竭死亡率和不良事件等。根据纳入标准与排除标准,最终纳入5篇文献,共有279例肝衰竭患者。结果 Meta分析结果显示,粒细胞集落刺激因子治疗肝衰竭患者的生存率显著高于对照组(RR=1.94,95%CI=1.37~2.26,P<0.0001)。结论 粒细胞集落刺激因子可显著提高肝衰竭患者生存率,几乎没有不良反应。尽管证据有限,但观察到G-CSF最终可使肝衰竭患者获益较大,在无法实施肝移植的患者中使用G-CSF成为一种合理的替代方法。

关键词: 粒细胞集落刺激因子, 肝衰竭, Meta分析

Abstract: Objective To systematically review the clinical efficacy and safety of G-CSF (granulocyte colony-stimulating factor) in treatment of patients with hepatic failure. Methods We searched PubMed, WanFang Database, the Cochrane Library, CNKI, CBM, VIP databases to collect RCTs (randomized clinical trials) of G-CSF in treatment of patients with hepatic failure, which were published before January, 2018. RCTs comparing the use of any regimen of G-CSF against placebo or no intervention in patients with ACLF were included. Primary outcomes included overal mortality, mortality due organ failure, and adverse events. We selected the retrieved studies according to the predefined inclusion and exclusion criteria, and evaluated the quality of included studies, a total of 5 studies involving 279 patients with hepatic failure were included. Results The results of meta-analysis showed that the survival rate in G-CSF group was significantly higher than that in control group [RR=1.94,95%CI=1.37-2.26,P<0.0001]. Conclusion G-CSF is more effective than the general supporting treatment for patients with hepatic failure, as it can increase the survival rate and has fewer adverse events. Although the evidence is still limited, the apparent benefit is observed that the use of G-CSF in ACLF patients as a reasonable alternative when liver transplantation is contraindicated or unavailable.

Key words: Granulocyte colony-stimulating factor, hepatic failure, Meta-analysis