益生菌对轻微型肝性脑病患者显性肝性脑病发生率影响的Meta分析

Abstract

目的 评价使用益生菌干预对轻微型肝性脑病患者显性肝性脑病发生率的影响。 方法 本研究根据PRISMA指南完成，PROSPERO注册号为CRD42022303995。检索PubMed、Web of Science、Cochrane Library、知网、万方数据库，收集建库至2021年11月有关益生菌干预治疗轻微型肝性脑病的研究。用RevMan 5.4进行Meta分析，不能合并的数据采用描述性分析。选择危险比(RR)和95%CI作为汇总指标。 结果 共纳入6篇文献，均为随机对照研究，共404例轻微型肝性脑病患者。结果表明益生菌干预可使轻微型肝性脑病患者显性肝性脑病的发生率降低54%(RR=0.46，95%CI：0.26~0.81，P=0.007)，并且能增加轻微型肝性脑病患者疾病的逆转率(RR=4.94，95%CI：2.82~8.66，P＜0.000 01)。 结论 益生菌能够降低轻微型肝性脑病患者显性肝性脑病的发生率，增加轻微型肝性脑病的逆转率，对轻微型肝性脑病患者预防显性肝性脑病的发生具有积极意义，为益生菌治疗轻微型肝性脑病提供了新的证据。

Alternate abstract:

Objective To review and analyze the effect of probiotics in preventing the overt hepatic encephalopathy (OHE) in patients with minimal hepatic encephalopathy (MHE). Methods Studies about this subject were searched in PubMed, Web of Science, Cochrane Library, Chinese journal full-text database (CNKI), WanFang data knowledge service platform (WanFang Data) from their establishment to November 2021. Meta-analysis was performed using RevMan 5.4. Description analysis was used for data that could not be pooled. The relative risk (RR) and 95% confidence interval (CI) were used to present pooled data. Results Six RCT studies with a total of 404 patients were included in this meta-analysis. The results showed probiotics users had a significant reduction of the OHE incidence, as compared with the controls (RR=0.46, 95%CI: 0.26 - 0.81; P=0.007), but an increase in the reversal MHE rate (RR=4.94, 95%CI: 2.82-8.66; P < 0.000 01). Conclusion This finding demonstrated that probiotics were able to effectively reduce the OHE incidence and improve the reversal MHE rate in the patients with MHE. This study could provide novel evidence for probiotics treatment of MHE.