夜间加餐对肝硬化患者影响的Meta分析

doi:10.3969/j.issn.1672-5069.2021.05.005

摘要/Abstract

摘要： 目的系统评价晚间加餐(LES)对肝硬化(LC)患者的疗效和安全性。方法在PubMe d、EMbase、The Cochrane Library、中国知网、万方数据库、维普数据库,结合手工检索进行了系统检索2000年1月至2020年8月发表的相关研究论文。应用RevMan5.3对这些研究进行了统计合并和分析。结果纳入包含492例病例的14项试验,有13项研究评估了LES后ALB的变化,结果表明,富含优质蛋白质和氨基酸的LES能提升ALB水平(MD =5.68,95％CI:1.78～9.59,P=0.004);有8项试验包括398例参与者,结果表明PAB比基线水平增加(SMD=3.87,95％CI:2.14～5.61,P<0.0001);有8项试验包括366例参与者,结果表明经过一段时期的LES后CHE较基线水平增加(SMD=0.95,95％CI:0.04～1.87,P=0.4);有4项试验在LES干预后,HGB较基线水平增加(MD=4.41,95％CI:0.001～8.82,P=0.05);在10项研究结果表明与基线比,LES干预后TBIL有所下降(MD=-22.62,95％CI:40.63～-4.62,P=0.01);6项研究发现在LES服用1～12 w后,显示RQ增加(MD=0.17,95％CI:-0.02～0.36,P=0.08);有5项研究脂肪、蛋白质和碳水化合物氧化率,在摄入LES后,蛋白质氧化速率呈下降趋势(MD=-4.07,95％CI:-7.22～-0.91,P=0.01),碳水化合物的利用显著增加(MD=8.47,95％CI:7.51～9.43,P<0.00001),脂肪氧化也显著降低(MD=-4.88,95％Cl:-7.73～-2.02,P=0.0008)。结论 LES可以改善LC患者的营养不良状态。

关键词: 肝硬化, 夜间加餐, Meta分析

Abstract: Objective The aim of this study was to evaluate the efficacy and safety of late evening snack (LES) in patients with liver cirrhosis (LC). Methods The systematic search was carried out in PubMed, EMbase, The Cochrane Library, China knowledge Network, Wanfang database and VIP database, and the articles published from January 2000 to August 2020 were retrieved systematically. RevMan5.3 was applied to conduct a statistical analysis. Results Fourteen trials involving 492 cases were included in this study; thirteen studies evaluated the changes of serum albumin levels after administration of LES, and the results showed that the high-quality proteins and amino acids-rich LES could increase serum albumin levels (MD =5.68,95％CI:1.78-9.59,P=0.004); eight clinical trials including 398 participants reported serum pre-albumin level was higher than the baseline (SMD=3.87,95％CI:2.14-5.61,P<0.0001); eight trials including a total of 366 participants reported that after a period of LES, serum CHE level was found to be higher than the baseline (SMD=0.95,95％CI:0.04-1.87,P=0.4); after LES intervention, HGB increased compared with baseline level (MD=4.41,95％CI:0.001-8.82,P=0.05) in 4 trials, and in 10 papers showed total serum bilirubin level decreased after LES intervention (MD=-22.62,95％CI:40.63--4.62,P=0.01); six studies reported an increase in RQ (MD=0.17,95％CI:-0.02-0.36,P=0.08) after taking LES for 1 to 12 weeks; there were 5 studies on fat, protein and carbohydrate oxidation rate, showed a downward trend in protein oxidation rate (MD=-4.07,95％CI:-7.22--0.91,P=0.01) , the utilization of carbohydrates increased significantly (MD=8.47,95％CI:7.51-9.43,P<0.00001), and fat oxidation decreased significantly (MD=-4.88,95%Cl:-7.73--2.02,P=0.0008) after LES. Conclusion LES could improve the malnutrition status of patients with LC.

Key words: Liver cirrhosis, Nocturnal snack, Meta-analysis

谭风雷, 吴亮亮, 邓泽润, 徐峥, 张洁, 张跃新. 夜间加餐对肝硬化患者影响的Meta分析[J]. 实用肝脏病杂志, 2021, 24(5): 625-628.

Tan Fenglei, Wu Liangliang, Deng Zerun, et al. Nocturnal snack in patients with liver cirrhosis: a Meta analysis[J]. Journal of Practical Hepatology, 2021, 24(5): 625-628.

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