患有肝硬化和上胃肠道出血的患者的预防性乳糖治疗:随机试验的元分析
Akash Roy1, Suprabhat Giri2, Ankita Singh3
1Institute of Gastrosciences and Liver, Apollo Multispecialty Hospital, Kolkata, India. . royakash12@gmail.com.
Journal of gastrointestinal and liver diseases : JGLD
|December 26, 2023
概括
预防性乳糖可显著减少肝硬化和急性上部胃肠道出血 (AUGIB) 的患者的明显肝脑病变 (HE). 虽然发生了腹等常见的副作用,但它们很少需要停止治疗,死亡率不受影响.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 药理学 药理学 是一个学科.
背景情况:
- 乳糖是公开肝脑病变 (HE) 的首要治疗方法.
- 它在肝硬化和急性上部胃肠道出血 (AUGIB) 患者的HE初级预防中的作用受到争议.
- 这一元分析评估了乳糖在这个特定的患者群体中用于HE预防.
研究的目的:
- 评估乳糖在预防明显肝脑病变 (HE) 的有效性.
- 评估乳糖对肝硬化和AUGIB患者死亡率的影响.
- 为了确定与预防性乳糖相关的不良事件的发生率和管理.
主要方法:
- 在三个数据库中进行了系统的文献搜索,截至2022年12月.
- 包括随机对照试验,比较乳糖与安慰剂在肝硬化和AUGIB患者.
- 风险比率和95%的置信区间被计算为二元结果.
主要成果:
- 分析了五项研究 (三项具有偏差低风险,两项具有中等风险).
- 乳糖显著降低了公开HE的风险 (RR 0.38;95% CI 0.23-0.62),需要治疗的数量为6.
- 没有观察到死亡率 (RR 0.71;95% CI 0.29-1.76) 的显著差异. 不良事件,包括腹 (34.7%),是常见的,但可控.
结论:
- 预防性乳糖有效降低了肝硬化患者在AUGIB后的HE发病率.
- 乳糖不影响这一群体的死亡率.
- 像腹这样的常见不良事件通常是可以控制的,通常不需要停止治疗.
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