肝素对轻中度活动性溃疡性结肠炎有效性与安全性的系统评价

摘要

目的：评价低分子肝素( low molecular weight heparin, LMWH)对轻中度活动性溃疡性结肠炎( ulcerative colitis, UC)的有效性和安全性。方法计算机检索Cochrane Library、PubMed、EMbase、CNKI、VIP和CBM数据库,检索时间从建库截止至2015年1月,由两名研究者按照纳入和排除标准筛选文献,评价方法学质量并提取资料后,采用RevMan5.3软件进行统计分析,同时进行亚组及敏感性分析。结果本研究共纳入6项随机对照试验( RCT)研究文献,包括轻中度活动性UC 447例,其中试验组223例,对照组224例。 meta分析结果显示：试验组总有效率优于对照组[RR=1.18,95%CI (1.05,1.33),P =0．005],完全缓解率优于对照组[RR =1.64,95%CI (1.32,2.04),P<0．00001],且不良反应发生率与对照组比较差异无统计学意义[RR=0.76,95%CI (0.48,1.21),P=0．25]。结论 LMWH 对轻中度活动性UC 有一定治疗效果且无明显不良反应。%Objective To evaluate the efficacy and safety of low molecular weight heparin ( LMWH) for mild-to-mod-erate active ulcerative colitis ( UC) . Methods The Cochrane Library, Pubmed, EMbase, CNKI, VIP Database and CBM Database were searched, and the retrieval time was from the establishment of the library to January 2015. Two reviewers inde-pendently retrieved literatures according to the inclusion and exclusion criteria, assessed the methodological quality of included trials and extracted data. Then the data analysis was performed by RevMan 5. 3 software, and subgroup analysis and sensitivity analysis were performed at the same time. Results Six studies of randomized controlled trial ( RCT) literatures involved in 447 cases of mild-to-moderate active UC, which included the test group (n=223) and the control group (n= 224). The re-sult of meta-analysis showed that the total efficacy rate of test group was better than that of control group [RR=1. 18, 95%CI (1. 05,1. 33), P=0. 005];the complete remission rate of test group was better than that of control group [RR=1. 64, 95%CI(1. 32,2. 04), P<0. 00001]. There was no significant difference in incidence of adverse reactions [RR=0. 76, 95%CI (0. 48,1. 21), P=0. 25] between the two groups. Conclusion LMWH for patients with mild-to-moderate active UC is ef-fective with no significant adverse effects.