氨基糖化物,万科米辛和美特罗尼达用于肝硬化和肝脏脑病变患者
Rebecca Jeyaraj1, Harry D Zacharias1, Sonam Vadera1
1UCL Institute for Liver & Digestive Health, Division of Medicine, Royal Free Campus, University College London, London, UK.
The Cochrane database of systematic reviews
|February 3, 2026
概括
这次审查发现了低确定性证据,即阿米诺糖化物可能会在肝脏脑病患者中略微增加死亡率和不良事件. 范科米辛和美特罗尼达的有效性仍然不确定.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 药理学 药理学是指药理学的学科.
- 胃肠病学 胃肠病学
背景情况:
- 肝脑病变 (HE) 是肝硬化的一个常见并发症,显著增加患病率和死亡率.
- 由肠道细菌产生的氨是HE病变发生的关键因素.
- 抗生素,如氨基糖化物,万科米辛和美特罗尼达正在探索调节肠道菌群和减少氨的生产.
研究的目的:
- 评估阿米诺糖化物,万科米辛和美特罗尼达在预防和治疗肝硬化患者肝脏脑病的疗效和安全性.
- 将这些抗生素与安慰剂,无干预,其他抗生素或其他活性剂进行比较.
主要方法:
- 进行了随机临床试验 (RCT) 的系统审查和元分析.
- 搜索包括多个数据库,直到2025年4月,以及试验注册和手动搜索.
- 包括24个涉及1405名参与者的RCT,其中22个被归类为具有高偏差风险的RCT.
主要成果:
- 所有比较的证据确定性低至非常低.
- 与其他药物相比,氨基糖化物可能会略微增加死亡率和严重不良事件.
- 与各种比较剂相比,关于氨基糖化物,万科米辛和美特罗尼达对HE,死亡率和不良事件的影响的证据不确定.
结论:
- 由于证据的确定性较低,氨基甘油酸对HE的益处尚不清楚.
- 氨基糖化物可能会增加死亡和不良事件的风险.
- 范科米辛和甲尼达对于HE的临床效用需要进一步研究.
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