奥美拉唑治疗尿毒症并发上消化道出血的疗效和安全性系统评价

Effectiveness and Safety of Omeprazole for Uremia Complicated with Upper Gastrointestinal Hemorrhage: A Systematic Review

关键词:  奥美拉唑  尿毒症  上消化道出血  系统评价

Key words:  omeprazole  uremia  upper gastrointestinal hemorrhage  system review

摘要:

目的 系统评价奥美拉唑治疗尿毒症并发上消化道出血的疗效和安全性。方法 检索Pubmed、EMbase、The Cochrane Library、EBSCO、CNKI、Wanfang Data、VIP、CBM(建库至2015年4月12日)，收集相关的随机对照试验研究(RCTs)，按照Cochrane 5.1手册，采用RevMan 5.3和STATA 11.0进行meta分析和评价。结果 与对照组相比，奥美拉唑治疗尿毒症并发上消化道出血的止血总有效率有显著性差异(P<0.000 01)。亚组分析显示：分别与H2受体拮抗剂组和空白对照组相比，奥美拉唑组止血总有效率有显著性差异(P<0.000 01或P<0.000 1)；判定72 h为有效终点和96 h为有效终点(P<0.000 01)均有统计学差异。奥美拉唑组与对照组发生药物不良反应无统计学差异。结论 奥美拉唑治疗尿毒症并发上消化道出血安全有效。但鉴于纳入本次研究有一定的局限性，还仍需设计良好的大规模临床随机对照研究来验证。

Abstract:

OBJECTIVE To evaluate effectiveness and safety of omeprazole treatment of uremia complicated with upper gastrointestinal hemorrhage. METHODS Such databases as Pubmed, EMbase, the Cochrane Library, EBSCO, CNKI, Wanfang Data, VIP, CBM were searched to collect RCTs. The bias risk assessment and meta analysis were conducted by RevMan 5.3 and STATA 11.0. RESULTS Compared with the control group, the total efficiency of omeprazole in the treatment of uremia complicated with upper gastrointestinal hemorrhage had significant difference(P<0.000 01). Compared with H₂ receptor antagonist group or blank control group, the total effective rate of hemostasis had significant difference (P<0.000 01 or P<0.000 1). The effective end judgment was different, results showed that 72 h or 96 h for efficacy endpoint both had statistical difference(P<0.000 01). The safety of omeprazole group and control group showed no significant difference between the occurrence of adverse drug reactions. CONCLUSION Omeprazole in the treatment of uremia complicated with upper gastrointestinal hemorrhage is safe and effective. But given in the study has certain limitations, and therefore a large sample of high-quality clinical trials still need to be verified.