聯合血液淨化治療高脂血症性胰腺炎療效的Meta分析

Meta-analysis of efficacy of combined blood purification therapy for hypertriglyceridemia-induced pancreatitis

洪偉君(HUNG Wai Kwan)；李達濱(LI Da Bin)；黃慧明(WONG Wai Meng)

高血脂性急性胰腺炎 ； 血漿置換 ； 血液淨化 ； Meta分析 ； Hypertriglyceridemia-induced pancreatitis ； Plasmapheresis ； Blood Purification ； Meta-analysis

鏡湖醫學

21卷1期（2021 / 06 / 01）

17 - 21

繁體中文;英文

目的：評價聯合血液淨化（Combined Blood Purification Therapy, CBPT）對高脂血症性胰腺炎（HTGP）患者的治療效果。方法：檢索網絡Cochrane Library、PudMed、Medline、中國知網、維普網和萬方數據庫，收集採用聯合血液淨化治療高脂血症性胰腺炎相關文獻，時間為建庫至2019年12月31日，採用RevMan5.3軟件對納入的研究進行處理。結果：共納入15個研究進行系統Meta分析，共計627例病人，其中CPBT組308例，對照組319例。結果顯示：CBPT組和對照組治療方法比較，可明顯縮短住院時間（WMD = -13.88，95% CI: -14.42～-13.33, P <0.01），明顯縮短禁食時間（WMD= - 6.66 95% CI:-7.03～- 6.30, P <0.01），降低APACHE Ⅱ 評分（WMD = - 2.57, 95% CI:-2.95～- 2.20, P <0.01），明顯降低TNF-α水平（WMD = - 6.50, 95% CI: -7.27 ～ - 5.72, P <0.01），明顯降低甘油三脂（WMD=-5.03, 95%CI:-7.58～-2.48, P <0.01），縮短血淀粉酶恢復正常時間（WMD=-2.68, 95%CI:-3.25～- 2.11, P <0.01）和尿淀粉酶恢復正常時間（WMD= -2.25, 95% CI:-2.60～- 1.19, P <0.01）。結論：聯合血液淨化治療高脂血症性胰腺炎可能有較好的臨床效果，值得進一步研究。

Objective: To assess the effect of combined blood purification therapy (CBPT) on hyperlipidemic acute pancreatitis (HLAP). Methods: Databases including Cochrane Library, PudMed, Medline, CNKI, VIP and Wanfang Database were searched. The related literature about randomized controlled trials of the effect of combined blood purification therapy (CBPT) on hyperlipidemic acute pancreatitis (HLAP) from the time of the establishment of database to the December 31,2019 was collected. RevMan 5.3 software was used to conduct Meta-analyze for each indicator. Results: Finally, 15 articles met the inclusion criteria and they were used in our analysis. A total of 627 patients were included, in which 308 cases of CBPT and 319 cases in control group. Meta-analysis showed that CBPT significantly decreased the length of hospitalization (WMD=- 13.88, 95% CI: -14.42~-13.33, P<0.01), duration of fasting (WMD=-6.66 95% CI:-7.03~-6.30, P<0.01), the acute physiology and chronic health evaluation (APACHE II) score (WMD=-2.57, 95% CI: -2.95~-2.20, P<0.01), the level of TNF-α(WMD=-6.50, 95% CI: -7.27~-5.72, P<0.01), the level of plasma triglyceride (WMD=-5.03,95% CI:-7.58~-2.48, P<0.01), time for plasma amylase (WMD=-2.68,95% CI:-3.25~-2.11, P<0.01) and urinary amylase (WMD=-2.25, 95% CI:-2.60~-1.19, P<0.01) to return to normal. Conclusion: CBPT may represent an effective therapy for patients with hypertriglyceridemia-induced pancreatitis (HTGP) and thus merits further investigation.