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Hepatology：非吸收性双糖治疗肝性脑病（荟萃分析）

2016-07-16 Seven L 译 MedSci原创

非吸收性双糖肝性脑病乳果糖
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近期发表在Hepatology的荟萃分析重申了非吸收性双糖(NADs)在治疗和预防明显和轻微肝性脑病(HE)方面的益处。2014年指南基于2004年的荟萃分析，推荐非吸收性双糖用于明显HE患者的治疗，但是不推荐其治疗轻微HE患者。来自哥本哈根大学医院的Lise L. Gluud和同事检索相关数据后，发现了38项评估乳果糖和乳糖醇治疗和预防HE疗效的随机对照试验，涉及1828例肝硬化患者。数据显示，

近期发表在Hepatology的荟萃分析重申了非吸收性双糖(NADs)在治疗和预防明显和轻微肝性脑病(HE)方面的益处。

2014年指南基于2004年的荟萃分析，推荐非吸收性双糖用于明显HE患者的治疗，但是不推荐其治疗轻微HE患者。

来自哥本哈根大学医院的Lise L. Gluud和同事检索相关数据后，发现了38项评估乳果糖和乳糖醇治疗和预防HE疗效的随机对照试验，涉及1828例肝硬化患者。

数据显示，与安慰剂相比，NADs对以下方面有益处：HE (RR = 0.63; 95% CI, 0.53-0.74) 、肝功能衰竭
、静脉曲张破裂出血、严重感染、自发性细菌性腹膜炎和肝肾综合征(RR = 0.42; 95% CI, 0.26-0.69)。可以降低明显HE患者的死亡率(RR = 0.36; 95% CI, 0.14-0.94)，但对轻微HE患者的死亡率没有效果。此外，NADs可以预防以下情况的进展：HE(RR = 0.47; 95% CI, 0.33-0.68)、严重不良事件(RR = 0.48; 95% CI, 0.33-0.7)，与死亡率的下降有关(RR = 0.63; 95% CI, 0.4-0.98)。

研究发现支持了EASL/AASLD的推荐：将乳果糖作为明显HE患者的一线治疗选择。对于轻微HE方面，还需要以后更多的研究。

原始出处：

Gluud LL, et al. Nonabsorbable disaccharides for hepatic encephalopathy: A systematic review and meta-analysis.Hepatology. 2016;doi:10.1002/hep.28598.

Meta-analysis reaffirms benefit of NADs in treating hepatic encephalopathy.Healio.July 15, 2016
 

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    2017-02-24 fangcong

    #荟萃分析#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1836892, encodeId=8fd4183689247, content=<a href='/topic/show?id=1f188e230c5' target=_blank style='color:#2F92EE;'>#荟萃分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87230, encryptionId=1f188e230c5, topicName=荟萃分析)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=fangcong, createdTime=Fri Feb 24 03:28:00 CST 2017, time=2017-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1666392, encodeId=3a331666392c3, content=<a href='/topic/show?id=55c6849451c' target=_blank style='color:#2F92EE;'>#脑病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84945, encryptionId=55c6849451c, topicName=脑病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db0126060584, createdName=showtest, createdTime=Fri Feb 03 22:28:00 CST 2017, time=2017-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145556, encodeId=413614555657, content=赞一个！好文章拜读了，认真学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Oct 11 20:35:01 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681316, encodeId=ffd71681316b7, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Sat May 20 13:28:00 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93410, encodeId=ac7393410b8, content=这个相关性比较创新, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Mon Jul 18 22:16:00 CST 2016, time=2016-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93411, encodeId=bdfa934119d, content=乳果糖一样的作用吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Mon Jul 18 22:16:00 CST 2016, time=2016-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426660, encodeId=8be11426660da, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Mon Jul 18 05:28:00 CST 2016, time=2016-07-18, status=1, ipAttribution=)]
    2017-02-03 showtest

    #脑病#

    0

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    2016-10-11 ylzr123

    赞一个！好文章拜读了，认真学习了。

    0

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    2017-05-20 venlin

    #荟萃#

    0

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    2016-07-18 doctorJiangchao

    这个相关性比较创新

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1836892, encodeId=8fd4183689247, content=<a href='/topic/show?id=1f188e230c5' target=_blank style='color:#2F92EE;'>#荟萃分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87230, encryptionId=1f188e230c5, topicName=荟萃分析)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=fangcong, createdTime=Fri Feb 24 03:28:00 CST 2017, time=2017-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1666392, encodeId=3a331666392c3, content=<a href='/topic/show?id=55c6849451c' target=_blank style='color:#2F92EE;'>#脑病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84945, encryptionId=55c6849451c, topicName=脑病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db0126060584, createdName=showtest, createdTime=Fri Feb 03 22:28:00 CST 2017, time=2017-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145556, encodeId=413614555657, content=赞一个！好文章拜读了，认真学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Oct 11 20:35:01 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681316, encodeId=ffd71681316b7, content=<a href='/topic/show?id=366b8e2299e' target=_blank style='color:#2F92EE;'>#荟萃#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87229, encryptionId=366b8e2299e, topicName=荟萃)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c12d27855367, createdName=venlin, createdTime=Sat May 20 13:28:00 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93410, encodeId=ac7393410b8, content=这个相关性比较创新, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Mon Jul 18 22:16:00 CST 2016, time=2016-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=93411, encodeId=bdfa934119d, content=乳果糖一样的作用吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Mon Jul 18 22:16:00 CST 2016, time=2016-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426660, encodeId=8be11426660da, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Mon Jul 18 05:28:00 CST 2016, time=2016-07-18, status=1, ipAttribution=)]
    2016-07-18 doctorJiangchao

    乳果糖一样的作用吧

    0

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    2016-07-18 gwc384

    #EPA#

    0