血液透析对百草枯中毒死亡率的疗效:一项系统评价和荟萃分析。

The efficacy of hemodialysis on paraquat poisoning mortality: A systematic review and meta-analysis.

作者信息

Eizadi-Mood Nastaran, Jaberi Danial, Barouti Zahra, Rahimi Alireza, Mansourian Marjan, Dorooshi Gholamali, Sabzghabaee Ali Mohammad, Alfred Sam

机构信息

Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

School of Medicine, Isfahan Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Med Sci. 2022 Sep 27;27:74. doi: 10.4103/jrms.jrms_235_21. eCollection 2022.

Abstract

BACKGROUND

Paraquat (PQ) poisoning is a serious public health concern, especially in developing countries, due to its easy access and lack of awareness of potential harms. No effective treatment has been reported yet. Conventional hemodialysis (HD) is still used in many centers for excreting PQ or reducing acute kidney injury, but there is no consensus on its efficacy. Therefore, we aimed to review the HD efficacy in PQ poisoning mortality.

MATERIALS AND METHODS

We searched Web of Science, PubMed, Excerpta Medical Database, Google Scholar, Scopus, Cochrane, Web of Knowledge, Pro-Quest, ScienceDirect, Springer, Clinical Key, Scientific Information Database, Magiran, and Iran-doc, in publications before January 1, 2020. We compared patients who underwent HD (Group 1) with those who did not (Group 2). The outcome was considered mortality/survival. The data were analyzed by Comprehensive Meta-analysis Software.

RESULTS

This systematic review and meta-analysis included five studies with a combined total of 203 patients. The patients in the Group 1 had higher mortality than Group 2 (odds ratio, 2.84; 95% confidence interval: 1.22-6.64; = 0.02). There was no evidence of publication bias ( value for Egger's test = 0.833).

CONCLUSION

Although HD did not affect the survival of patients, other variables such as the amount of ingested PQ, poisoning severity, the time between PQ ingestion and the start of HD, duration, and times of HD sessions may influence the results regarding mortality.

摘要

背景

百草枯(PQ)中毒是一个严重的公共卫生问题,尤其是在发展中国家,因为其易于获取且人们对潜在危害缺乏认识。目前尚未有有效的治疗方法被报道。许多中心仍在使用传统血液透析(HD)来排出PQ或减轻急性肾损伤,但其疗效尚无定论。因此,我们旨在综述HD对PQ中毒死亡率的疗效。

材料与方法

我们检索了科学网、PubMed、医学文摘数据库、谷歌学术、Scopus、考克兰图书馆、知识网络、Pro-Quest、ScienceDirect、施普林格、临床关键数据库、科学信息数据库、Magiran和伊朗文献数据库,检索截至2020年1月1日之前发表的文献。我们将接受HD治疗的患者(第1组)与未接受HD治疗的患者(第2组)进行比较。观察指标为死亡率/生存率。数据采用综合荟萃分析软件进行分析。

结果

本系统评价和荟萃分析纳入了5项研究,共计203例患者。第1组患者的死亡率高于第2组(比值比,2.84;95%置信区间:1.22 - 6.64;P = 0.02)。没有证据表明存在发表偏倚(Egger检验的P值 = 0.833)。

结论

虽然HD对患者的生存没有影响,但其他变量,如摄入的PQ量、中毒严重程度、PQ摄入至HD开始的时间、HD疗程的持续时间和次数等,可能会影响死亡率结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe8f/9639714/283b2791c75c/JRMS-27-74-g001.jpg

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