关键词: 肝衰竭, 糖皮质激素, Meta分析, 疗效

Abstract: Objective To systematically review the clinical efficacy and safety of glucocortioids in treatment of patients with hepatic failure. Methods Databases including PubMed,The Cochrane Library,CNKI,VIP,WanFang Data were searched for the studies on glucocorticoids for the treatment of patients with hepatic failure from inception to January 1st,2015. Two reviewers independently screened literatures,extracted data and evaluated methodological quality. Then meta-analysis was conducted by using RevMan 5.2 software. Results A total of 16 studies involving 1148 patients were included. The Results of meta-analysis showed that the glucocorticoids can significantly improve the total curative effect [RR=1.42,95%CI（1.27,1.58）,P<0.00001],reduce serum bilirubin levels [MD=-84.36,95%CI（-115.70,-53.02）,P<0.00001],improve PTA [MD=16.96,95%CI（3.46,30.47）,P=0.01], and significantly reduced mortality [RR=0.29,95%CI（0.20,0.43）,P<0.00001];The adverse events such as infections and bleedings had not significantly increased;Funnel plot showed the graph was symmetrical and might exist publication bias. Conclusions Gorticosteroids is more effective than the general supporting treatment for patients with hepatic failure, as it can reduce the mortality rate without increasing the adverse events.

Key words: Hepatic failure, Glucocorticoids, Meta-analysis, Efficacy