熊去氧胆酸对肝脏标志物的影响：随机安慰剂对照临床试验的系统评价和荟萃分析
Effect of ursodeoxycholic acid on liver markers: A systematic review and meta-analysis of randomized placebo-controlled clinical trials.
作者信息
Simental-Mendía Mario, Sánchez-García Adriana, Simental-Mendía Luis E
机构信息
Department of Orthopedics and Traumatology, Hospital Universitario "Dr. José E. González", Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico.
Endocrinology Division, Hospital Universitario "Dr. José E. González", Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico.
出版信息
Br J Clin Pharmacol. 2020 Aug;86(8):1476-1488. doi: 10.1111/bcp.14311. Epub 2020 Apr 27.
AIM
The objective of this meta-analysis was to evaluate the effect of ursodeoxycholic acid (UDCA) therapy on serum liver function tests.
METHODS
PubMed, Web of Science, Scopus and Google Scholar databases were searched to identify randomized placebo-controlled trials assessing the impact of UDCA on hepatic parameters. Meta-analysis was conducted using a random-effects model and sensitivity analysis through the leave-one-out method in the Review Manager statistical software version 5.3.
RESULTS
After UDCA treatment, meta-analysis revealed a significant reduction of alanine aminotransferase (weighted mean difference [WMD]: -15.28 U/L, 95% confidence interval [CI]: -23.42, -7.15, P = 0.0002, I = 97%), aspartate aminotransferase (WMD: -16.13 U/L, 95% CI: -23.84, -8.42, P < 0.0001, I = 97%), gamma-glutamyl transferase (WMD: -23.29 U/L, 95% CI: -33.97, -12.61, P < 0.0001, I = 97%), alkaline phosphatase (WMD: -93.80 U/L, 95% CI: -126.36, -61.25, P < 0.0001, I = 95%) and bilirubin (WMD: -0.18 U/L, 95% CI: -0.35, -0.01, P = 0.04, I = 93%), but not significant changes in albumin levels (WMD: 0.10 U/L, 95% CI: -0.05, 0.24, P = 0.18, I = 80%).
CONCLUSION
The results of the present meta-analysis suggest a hepatoprotective effect of UDCA by reducing serum liver parameters.
目的
本荟萃分析的目的是评估熊去氧胆酸（UDCA）治疗对血清肝功能检查的影响。
方法
检索PubMed、Web of Science、Scopus和谷歌学术数据库，以确定评估UDCA对肝脏参数影响的随机安慰剂对照试验。在Review Manager 5.3统计软件中使用随机效应模型进行荟萃分析，并通过逐一剔除法进行敏感性分析。
结果
UDCA治疗后，荟萃分析显示谷丙转氨酶显著降低（加权平均差[WMD]：-15.28 U/L，95%置信区间[CI]：-23.42，-7.15，P = 0.0002，I² = 97%）、谷草转氨酶（WMD：-16.13 U/L，95% CI：-23.84，-8.42，P < 0.0001，I² = 97%）、γ-谷氨酰转移酶（WMD：-23.29 U/L，95% CI：-33.97，-12.61，P < 0.0001，I² = 97%）、碱性磷酸酶（WMD：-93.80 U/L，95% CI：-126.36，-61.25，P < 0.0001，I² = 95%）和胆红素（WMD：-0.18 U/L，95% CI：-0.35，-0.01，P = 0.04，I² = 93%），但白蛋白水平无显著变化（WMD：0.10 U/L，95% CI：-0.05，0.24，P = 0.18，I² = 80%）。
结论
本荟萃分析结果表明UDCA通过降低血清肝脏参数具有肝脏保护作用。
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