胸腺肽α1治疗肝衰竭疗效的Meta分析

Efficacy of thymosin alpha1 on liver failure: a meta-analysis

摘要:

目的 系统评价胸腺肽α1治疗肝衰竭的疗效。方法 通过检索数据库中胸腺肽α1治疗肝衰竭的随机对照研究和临床对照研究，对患者病死率、丙氨酸氨基转移酶、总胆红素及凝血酶原活动度的文献，应用Meta分析的方法以比值比（R）或加权平均数（WMD）为效应量进行合并分析。结果 经过筛选共纳入16项随机对照试验和临床对照研究，合计1 208例患者。Meta分析结果显示：与内科综合治疗相比，胸腺肽α1治疗肝衰竭可以降低病死率［R=0.36（95% CI：0.26，0.49）］，降低丙氨酸氨基转移酶［MD=-28.46（95% CI：-38.62，-18.30）］和总胆红素［MD=-91.90（95% CI：-129.25，-54.55）］水平，提高凝血酶原活动度［MD=20.38（95% CI：13.46，27.29）］水平。结论 与内科综合治疗组比较，加用胸腺肽α1可降低病死率，改善患者的总胆红素、丙氨酸氨基转移酶和凝血酶原活动度水平。

Abstract:

Objective To systemically investigate the efficacy of thymosin alpha1 on the patients with liver failure.Methods We collected the literatures on thymosin alpha1 used to treat the patients with liver failure in randomized controlled trails (RCTs) and clinical controlled trial (CCT). All these clinical trials were carried out by comparing with routine comprehensive medical treatment liver failure. The total fatality rate, the serum levels of alanine aminotransferase (ALT), total bilirubin (TBIL), and prothrombin activity (PTA) were collected. Odds ratio (OR) was applied to evaluate the effect of thymosin alpha1 on improving case fatality. Weighted mean differences (WMD) was applied to evaluate the effect of thymosin alpha1on improving ALT, TBIL, and PTA.Results There were only 16 literatures and 1208 patients obtained. Compared with routine comprehensive medical treatment, combination with thymosin alpha1 successfully reduce mortality [R = 0.36, (95% CI: 0.26, 0.49)], ALT [MD = -28.46, (95% CI: -38.62, -18.30)], and TBIL [MD = -91.90, (95% CI: -129.25, -54.55)], and improve PTA [MD = 20.38, (95% CI: 13.46, 27.29)].Conclusions Combination with thymosin alpha1 can significantly reduce the fatality rate and improve the serum levels of ALT, TBIL, and PTA than only routine comprehensive medical treatment in patients with liver failure.