严重脓毒症患者补充左旋肉碱：随机对照试验的系统评价和荟萃分析。
The supplementation of L-carnitine in critically ill patients with sepsis: a systematic review and meta-analysis of randomized controlled trials.
机构信息
Department of Emergency, Emergency General Hospital, XiBaHe South Road 29, Chaoyang District, Beijing, 100028, People's Republic of China.
Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing, 100039, People's Republic of China.
出版信息
Eur J Med Res. 2024 Oct 5;29(1):488. doi: 10.1186/s40001-024-02087-w.
OBJECTIVES
The evidence suggests that L-carnitine may reduce mortality in critically ill patients with sepsis. However, the conclusions of different studies are inconsistent. A meta-analysis was conducted to evaluate the effect of L-carnitine compliance on mortality in patients with sepsis.
METHODS
A search of the PubMed, Embase, and Cochrane Library databases was conducted on 1 June 2024. The risk ratio (RR) was pooled with a 95% confidence interval (CI) for dichotomous data. The publications were subjected to a review in accordance with the guidelines set forth in the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). This study has been registered with INPLASY (number INPLASY202460086).
RESULTS
A total of 356 patients were included in four randomized controlled trials. The results indicated that L-carnitine supplementation was not associated with 28-day mortality in sepsis patients (RR: 0.65; 95% CI 0.33-1.28; I = 70%; P = 0.21). And there was no significant effect on 12-month mortality (RR: 0.72; 95% CI 0.47-1.11; I = 0%; P = 0.14) compared to placebo.
CONCLUSIONS
The use of L-carnitine was not found to be significantly correlated with 28-day or 12-month mortality in patients with sepsis.
目的
有证据表明左旋肉碱可降低脓毒症重症患者的死亡率。然而，不同研究的结论并不一致。因此，我们进行了一项荟萃分析，以评估左旋肉碱给药对脓毒症患者死亡率的影响。
方法
我们于 2024 年 6 月 1 日检索了 PubMed、Embase 和 Cochrane Library 数据库。使用二项分类数据汇总风险比（RR）及其 95%置信区间（CI）。按照 Cochrane 手册和系统评价和荟萃分析的首选报告项目（PRISMA）的指南对出版物进行了审查。本研究已在 INPLASY（编号 INPLASY202460086）注册。
结果
共有四项随机对照试验纳入了 356 名患者。结果表明，脓毒症患者补充左旋肉碱与 28 天死亡率无关（RR：0.65；95%CI 0.33-1.28；I²=70%；P=0.21）。与安慰剂相比，12 个月死亡率也没有显著影响（RR：0.72；95%CI 0.47-1.11；I²=0%；P=0.14）。
结论
与安慰剂相比，使用左旋肉碱并未显著降低脓毒症患者的 28 天或 12 个月死亡率。
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