Department of Burns, Changhai Hospital, Second Military Medical University, Shanghai, China.
Am J Emerg Med. 2013 Aug;31(8):1170-5. doi: 10.1016/j.ajem.2013.04.020. Epub 2013 Jun 21.
Recently, several studies were conducted to investigate the effect of selenium supplementation in septic patients. However, no consistent conclusion was made. Thus, we aimed to systematically summarize the available randomized controlled trials (RCTs) to evaluate the effect of selenium supplementation on important clinical outcomes in septic patients.
A systematic literature search of Pubmed, Embase, and the Cochrane Central Register of Controlled Trials was conducted (up to August 25, 2012). RCTs were included if they reported the effect of selenium supplementation on the treatment of septic patients. A fixed-effect model was used, and in the case of significant heterogeneity, a random-effects model was employed.
Five studies with a total of 530 patients were included. Pooled analysis showed that selenium supplementation did not reduce all-cause mortality (relative risk [RR] = 0.89, 95% confidence interval [CI]: 0.73-1.07, P = .21), hospital-acquired pneumonia (RR = 1.15, 95% CI: 0.73-1.82, P = .55), or length of intensive care unit stay (weighted mean differences = 2.32 days, 95% CI: -0.05 to 4.69; P = .05). In addition, no significant difference was observed regarding adverse events between groups (RR = 0.97, 95% CI: 0.72-1.33, P = .87).
The present meta-analysis showed no benefit of selenium supplementation in patients with sepsis. Due to the limited number of RCTs included, more prospective multicenter clinical trials on selenium therapy in septic patients are warranted in the future.
最近有几项研究调查了硒补充剂对脓毒症患者的影响，但未得出一致的结论。因此，我们旨在系统地总结现有的随机对照试验（RCT），以评估硒补充剂对脓毒症患者重要临床结局的影响。
对 Pubmed、Embase 和 Cochrane 对照试验中心注册库进行系统文献检索（截至 2012 年 8 月 25 日）。如果研究报告了硒补充剂对脓毒症患者治疗的影响，则纳入 RCT。采用固定效应模型，如存在显著异质性，则采用随机效应模型。
纳入 5 项共 530 例患者的研究。汇总分析显示，硒补充剂并未降低全因死亡率（相对风险 [RR] = 0.89，95%置信区间 [CI]：0.73-1.07，P =.21）、医院获得性肺炎（RR = 1.15，95% CI：0.73-1.82，P =.55）或重症监护病房住院时间（加权均数差 = 2.32 天，95% CI：-0.05 至 4.69；P =.05）。此外，两组间不良反应发生率无显著差异（RR = 0.97，95% CI：0.72-1.33，P =.87）。
本荟萃分析显示，脓毒症患者补充硒并无获益。由于纳入的 RCT 数量有限，未来有必要开展更多针对脓毒症患者硒治疗的前瞻性多中心临床试验。
