Second Clinical College, Chongqing Medical University, Chongqing, China.
Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
PLoS One. 2022 Aug 30;17(8):e0273231. doi: 10.1371/journal.pone.0273231. eCollection 2022.
Modulation of the gut microbiome could favorably alter the hepatic venous pressure gradient (HVPG) in cirrhosis and portal hypertension (PH).
This meta-analysis was to evaluate the effects of microbiome-targeted therapies (MTTs) on HVPG in persons with cirrhosis and PH.
PubMed, The Cochrane Library, Embase, Web of Science and Scopus were searched for randomized clinical trials (RCTs) analyzing the effects on HVPG in people with cirrhosis who received MTTs. Clinical outcomes were pooled using RevMan5.3 software. A trial sequential analysis was applied to calculate the required information size and evaluate the credibility of the meta-analysis results.
A total of six studies were included. MTTs were associated with a reduction of 1.22 mm Hg in HVPG (95% CI: -2.31, -0.14 mmHg, P = 0.03). Subgroup analysis showed a greater reduction with longer duration (-1.88 mmHg;95% CI: -3.23, -0.53; P = 0.006). In the trial sequential analysis of HVPG reduction, the cumulative Z curve crossed the traditional significance boundary without the achievement of required information size (330).
MTTs may be associated with a reduction in HVPG in patients with cirrhosis and PH. Microbiome-targeted therapies merit additional large-sample studies to define the efficacy of HVPG.
PROSPERO 2020: CRD4202021609.
调节肠道微生物组可能有利于改变肝硬化和门静脉高压症（PH）患者的肝静脉压力梯度（HVPG）。
本荟萃分析旨在评估针对微生物组的治疗（MTT）对肝硬化和 PH 患者 HVPG 的影响。
检索 PubMed、The Cochrane Library、Embase、Web of Science 和 Scopus，分析接受 MTT 的肝硬化患者 HVPG 的随机对照试验（RCT）。使用 RevMan5.3 软件汇总临床结果。应用试验序贯分析计算所需信息量并评估荟萃分析结果的可信度。
共纳入 6 项研究。MTTs 与 HVPG 降低 1.22mmHg 相关（95%CI：-2.31，-0.14mmHg，P=0.03）。亚组分析显示，治疗时间更长时降低幅度更大（-1.88mmHg；95%CI：-3.23，-0.53；P=0.006）。在 HVPG 降低的试验序贯分析中，累积 Z 曲线穿过传统的显著性边界，但未达到所需信息量（330）。
MTTs 可能与肝硬化和 PH 患者的 HVPG 降低相关。针对微生物组的治疗值得进一步开展大型样本研究，以明确 HVPG 的疗效。
PROSPERO 2020：CRD4202021609。
