目的 系统评价预防使用质子泵抑制剂对慢性肾脏病患者上消化道出血的有效性和安全性.方法 计算机检索英文数据库(PubMed、Web of Science、ProQuest等)和中文数据库(中国知网、万方数据库、维普资讯中文期刊服务平台、中国生物医学数据库、百度学术、谷歌学术等),检索时限均从建库至2023年3月,以慢性肾脏病患者预防使用质子泵抑制剂的随机对照临床研究为文献检索类型,由两名研究者独立对纳入研究的质量进行数据提取和文献质量评价,并采用RevMan 5.4软件对纳入的文献进行Meta分析.结果 共纳入9项研究,包括1 530例患者.Meta分析结果显示,上消化道出血率[RR=0.18,95%CI=(0.1,0.3),P<0.000 01],病死率[RR=0.12,95%CI=(0.02,0.63),P=0.01],胃液pH值[MD=2.00,95%CI=(-0.41,4.40),P=0.10],治疗组与对照组上消化道出血率及病死率比较,差异有统计学意义(P均<0.05);两组胃液pH值比较,差异无统计学意义(P>0.05).结论 预防使用质子泵抑制剂能降低慢性肾脏病患者上消化道出血率及病死率.
Meta-analysis of the Clinical Effect of Proton Pump Inhibitors on Upper Gastrointestinal Bleeding in Patients with Chronic Kidney Disease
Objective To systematically evaluate the effectiveness and safety of prophylactic use of proton pump in-hibitors on upper gastrointestinal bleeding in patients with chronic kidney disease.Methods Computerized searches of English databases(PubMed,Web of Science,ProQuest,etc.)and Chinese databases(CNKI,Wanfang Data,VIP Infor-mation Chinese Journal Service Platform,China Biomedical Database,Baidu Scholar,Google Scholar,etc.)were con-ducted from database establishment to March 2023.Random controlled clinical studies on the prevention of the pro-phylactic use of proton pump inhibitors in patients with chronic kidney disease were used as literature search types.Two researchers independently extracted data and evaluated the quality of the included studies,and Meta-analysis was performed on the included literature using RevMan 5.4 software.Results A total of nine studies including 1 530 patients were included.The results of Meta-analysis showed upper gastrointestinal bleeding rate[RR=0.18,95%CI=(0.1,0.3),P<0.000 01],morbidity and mortality[RR=0.12,95%CI=(0.02,0.63),P=0.01],gastric juice pH[MD=2.00,95%CI=(-0.41,4.40),P=0.10].The upper gastrointestinal bleeding rate and morbidity and mortality were compared between the treatment group and the control group,and the differences were statistically significant(both P<0.05).And there was no statistically significant difference in gastric fluid pH between the two groups(P>0.05).Conclusion Prophylactic use of proton pump inhibitors can reduce the rate of upper gastrointestinal bleeding and mortality in pa-tients with chronic kidney disease.
万方数据
维普
