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选择性血管加压素V2受体拮抗剂治疗肝硬化腹水的Meta分析
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Journal Article
选择性血管加压素V2受体拮抗剂治疗肝硬化腹水的Meta分析
2013
Overview
目的评价选择性血管加压素V2受体拮抗剂治疗肝硬化腹水的疗效及安全性。方法检索PubMed、EMBASE、Web of Science、The Cochrane Central Register of Controlled Trials、中国期刊全文数据库、中国科技期刊数据库（维普）、万方数字化期刊全文数据库等关于选择性血管加压素V2受体拮抗剂治疗肝硬化腹水疗效及安全性的随机对照试验（RCT）,使用RevMan5.0版软件对纳入的研究进行Meta分析。结果共9项RCT包含1884例患者符合入选标准。Meta分析结果显示：①治疗组患者体重降低幅度明显大于安慰剂组（WMD=–1.98kg,95%CI：–3.24~–0.72kg,P=0.002）;治疗组患者血清钠升高幅度明显大于安慰剂组（WMD=3.74mmol/L,95%CI：0.91~6.58mmol/L,P=0.01）;治疗组患者腹水恶化的比例较安慰剂组明显降低（RR=0.51,95%CI：0.34~0.77,P=0.001）。②治疗组患者尿量增加幅度明显大于安慰剂组（WMD=1437.65ml,95%CI：649.01~2226.30ml,P=0.0004）;治疗组患者血肌酐与安慰剂组相比差异无统计学意义（WMD=–3.49μmol/L,95%CI：–12.54~5.56μmol/L,P=0.45）。③治疗组患者心率、收缩压、舒张压和病死率与安慰剂组相比差异无统计学意义（P〉0.05）;治疗组其他不良反应发生率（P=0.003）高于安慰剂组;治疗组死亡率与安慰剂组相比差异无统计学意义（P=0.49）。结论选择性血管加压素V2受体拮抗剂可以改善肝硬化腹水和稀释性低钠血症,并且对心脏和肾脏无明显影响,不良反应相对较少,可能成为肝硬化腹水治疗的一种新选择。
