Daures J P, Peray P, Bories P, Blanc P, Yousfi A, Michel H, Gremy F
Départements d'Information Médicale des CHR de Nîmes et de Montpellier.
Gastroenterol Clin Biol. 1991;15(3):223-8.
A meta-analysis of 10 randomized trials comparing steroid therapy with placebo or abstention was performed. Trials were pooled for severity of acute alcoholic hepatitis and time of analysis. Papers with survival analyses at one and three months were included. The robustness of this meta-analysis was analysed after exclusion of trials analysing survival at three months only, trials including mild forms, or atypical trials. Comparisons were made use the Der Simonian-Laird and Mantel-Haenszel-Peto methods. All results were statistically significant. However, if only one medium size trial were to be added, the results would no longer be significant. Taking into account the complications of steroid therapy, we conclude that further clinical trials are necessary to confirm the effectiveness of steroid therapy, especially for the group of patients with severe alcoholic hepatitis.
我们进行了一项荟萃分析，纳入10项比较类固醇疗法与安慰剂或不治疗的随机试验。根据急性酒精性肝炎的严重程度和分析时间对试验进行汇总。纳入了在1个月和3个月时进行生存分析的论文。在排除仅分析3个月生存率的试验、纳入轻度病例的试验或非典型试验后，对该荟萃分析的稳健性进行了分析。采用Der Simonian-Laird法和Mantel-Haenszel-Peto法进行比较。所有结果均具有统计学意义。然而，如果仅增加一项中等规模的试验，结果将不再具有统计学意义。考虑到类固醇疗法的并发症，我们得出结论，有必要进行进一步的临床试验，以证实类固醇疗法的有效性，特别是对于重症酒精性肝炎患者群体。
