| 陈杰,钱超.持续肾脏替代联合血必净治疗对脓毒症炎症因子和免疫指标的影响的系统性分析[J].实用中西医结合临床,2021,21(13): |
| 持续肾脏替代联合血必净治疗对脓毒症炎症因子和免疫指标的影响的系统性分析 |
| The Efficacy of continuous renal replacement therapy combined with xuebijing on the inflammatory factors and immune indexes for treating sepsis in the Chinese population: A Systematic Review and Meta-analysis |
| 投稿时间：2021-04-06 修订日期：2021-06-03 |
| DOI： |
| 中文关键词: 脓毒症 血必净 连续性肾脏替代 随机对照试验 系统评价 Meta 分析 |
| 英文关键词: sepsis xuebijing CRRT Randomzed conrolled trial System Review Meta-analysis. |
| 基金项目: |
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| 摘要点击次数: 485 |
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| 中文摘要: |
| 脓毒症在全球发病率和死亡率中占相当大的比例。脓毒症的治疗目标是恢复免疫系统和炎症系统的平衡。本研究系统性回顾了持续肾脏替代联合血必净对脓毒症患者炎症反应和免疫功能的影响。方法：计算机检索PubMed、WanFangData、CNKI、CENTRAL等电子数据库，查找持续肾脏替代联合血必净对脓毒症患者炎症反应和免疫功能的影响的随机对照试验，检索时间均从建库至2019年06月。由两位研究者进行资料提取和质量评价后，采用RevMan5.3软件进行Meta分析。结果：纳入5个RCT，共399例患者（对照组为常规治疗加血必净治疗，共186例患者；观察组为常规治疗基础上血必净联合连续性肾脏替代，共213例患者）。同对照组相比，血必净联合连续性肾脏替代组可降低IL-6、TNF-α、WBC水平，同时升高CD4+水平，两组差异有统计学意义（P<0.05）；而血必净联合肾脏替代组在降低CD3+水平同对照组相比，差异无统计学意义( P=0.14)。结论：持续性肾脏替代联合血必净能有效改善患者炎症反应，增强免疫功能；持续性肾脏替代联合血必净治疗脓毒症可值得被临床应用。受纳入研究数量及质量限制，本系统评价结论仍需进一步开展更多大样本、严格设计的随机对照试验加以验证。 |
| 英文摘要: |
| Sepsis contributes considerably to global morbidity and mortality.The therapeutic goal of the management of sepsis is restoring balance to the immune system and the inflammatory system. Thus,this research consisted of a systematic review of the effect of continuous renal replacement combined with xuebijing on inflammatory response and immune function in patients with sepsis.Methods: I searched the randomized controlled trials about the effect of continuous renal replacement combined with xuebijing on inflammatory response and immune function in patients with sepsis from the PubMed (1998～1990-2019.06), Wanfang Data (1990～2019.06), China National Knowledge Infrastructure (1979～2019.06). After data extraction and quality evaluation，I got the Meta-analysis from RevMan 5.3 software.Results: Five RCTs involving 399 patients were included (186 patients in the xuebijing group ， which xuebijing was used on the basis of routine treatment and 213 patients in the continuous renal replacement combined with xuebijing group, which continuous renal replacement combined with xuebijing was used on the basis of routine treatment).Compared with the xuebijing group, this Meta-analysis showed that the continuous renal replacement combined with xuebijing group could reduce the level of IL-6、TNF-α、WBC，and increase the level of CD4+，and differences exist statistical significance（P<0.05）. But there was no significant difference in the level of CD3+between the two groups ( P=0.14).Conclusion: Compared with the xuebijing group, the total effect of continuous renal replacement combined with xuebijing in the treatment of the inflammatory factors and immune indexes in patients with sepsis is better. continuous renal replacement combined with xuebijing for the sepsis is acceptable．However，all these findings should be further confirmed with more large sample and well-designed RCTs. |
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