| 摘要: |
| 目的:评估低分子肝素联合糖皮质激素治疗小儿肾病综合征(NS)的疗效及安全性。 方法:检索 PubMed、the Cochrane Library、EMBase、中国知网、中国生物医学文献数据库、维普、万方数据库,检索时间从建库至 2021 年 3 月,收集低分子肝素联合 糖皮质激素治疗小儿 NS 的临床随机对照试验(RCT),根据 Cochrane 推荐的偏倚风险评估方法对纳入的 RCT 研究进行风险评估,使用 RevMan 5. 3 软件进行统计学分析。 结果:共纳入 16 篇 RCT,病例共计 1 348 例。 Meta 分析结果显示:与单用糖皮质激素(泼尼松)治疗小儿 NS 相比,低分子肝素+泼尼松治疗在活化部分凝血活酶时间、血浆凝血酶原时间、不良反应发生率方面差异无统计学意义(P 均>0. 05),在改善 24 h 尿蛋白定量、血清白蛋白、尿素氮、血肌酐清除率、血肌酐及血浆胆固醇水平方面差异有统计学意义(P 均<0. 05)。 结论:低分子肝素联合糖皮质激素较单用激素治疗小儿 NS 疗效更优,但仍需大样本、多指标的RCT 对远期疗效及药物不良反应等展开深入评估。 |
| 关键词: 低分子肝素 糖皮质激素 肾病综合征 Meta 分析 |
| DOI：10. 13407/ j. cnki. jpp. 1672-108X. 2023. 09. 004 |
|
| 基金项目: |
|
| Meta-Analysis on Efficacy and Safety of Low Molecular Weight Heparin Combined with Glucocorticoid in the Treatment of Children with Nephrotic Syndrome |
| Wang Liping, Cao Lu, Wang Aiyu |
| (Children’s Hospital of Nanjing Medical University, Nanjing 210024, China) |
| Abstract: |
| Objective: To evaluate the efficacy and safety of low molecular weight heparin combined with glucocorticoid in the treatment of children with nephrotic syndrome ( NS). Methods: PubMed, the Cochrane Library, EMBase, CNKI, CBM, VIP and Wanfang databases were retrieved from the establishment of the databases to Mar. 2021. Clinical randomized controlled trials (RCT) on the treatment of children with NS with low molecular weight heparin combined with corticosteroids were collected. Risk of bias assessment
was performed on the included RCT by the bias risk assessment method recommended by Cochrane, and statistical analysis was conducted by using RevMan 5. 3 software. Results: A total of 16 RCT and 1,348 cases were included. Meta-analysis showed that compared with glucocorticoid (prednisone) alone in the treatment of children with NS, the differences with low molecular weight heparin + prednisone treatment were not statistically significant in activated partial thromboplastin time, plasma plasminogen time, and incidence of adverse drug reactions ( P > 0. 05), yet the differences in improvement of 24-h urinary protein quantification, serum albumin, urea nitrogen, creatinine clearance rate, creatinine, and plasma cholesterol levels were statistically significant ( P < 0. 05). Conclusion: Compared with glucocorticoid alone in the treatment of children with NS, the efficacy of low molecular weight heparin combined with glucocorticoid is more significant. However, further evaluation of the long-term effectiveness and adverse drug reactions still requires large-sample, multi-index RCT. |
| Key words: low molecular weight heparin glucocorticoid nephrotic syndrome Meta-analysis |
