International Medicine and Health Guidance News ›› 2022, Vol. 28 ›› Issue (24): 3544-.DOI: 10.3760/cma.j.issn.1007-1245.2022.24.030

• Literature Analysis • Previous Articles     Next Articles

Evaluation of ursodeoxycholic acid for primary sclerosing cholangitis: a meta-analysis

Wang Yanping1, Wang Huan2, Liang Haijun1, Gao Haili1, Wang Xinwei1, Yang Daokun1   

  1. 1新乡医学院第一附属医院感染科,卫辉 453100;2解放军总医院第五医学中心药学部,北京 100039
  • Received:2022-08-12 Online:2022-12-15 Published:2022-12-18
  • Contact: Yang Daokun, Email: dk13949620669@163.com

熊去氧胆酸对原发性硬化性胆管炎疗效的meta分析

王燕平1  王欢2  梁海军1  高海丽1  王新伟1  杨道坤1   

  1. 1新乡医学院第一附属医院感染科,卫辉 453100;2解放军总医院第五医学中心药学部,北京 100039
  • 通讯作者: 杨道坤,Email:dk13949620669@163.com

Abstract: Objective To evaluate the efficacy of ursodeoxycholic acid (UDCA) for primary sclerosing cholangitis (PSC) by the evidence-based pharmaceutical method. Methods The trials of UDCA in the treatment of PSC published at home and abroad were collected, and high-quality literatures meeting the standards were screened and used for meta-analysis. The quality of the included studies was evaluated by Q test and I2 test and analyzed by Stata 13.0. The deadline for literature publishing was May 30, 2019. Results Five studies with a total of 364 patients were included. Liver function indexes [alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin (ALB), and total bilirubin (TBIL)] were significantly improved in the UDCA group compared with those in the placebo group (SMD=-0.43, 95%CI [-0.65, -0.22], P<0.001; SMD=-0.90, 95%CI [-1.24, -0.56], P<0.001; SMD=-0.01, 95%CI [-0.28, 0.27], P<0.001; SMD=0.00, 95%CI [-0.20, 0.21], P<0.001; SMD=-0.31, 95%CI [-0.52, -0.10], P=0.001). In terms of immunoglobulin (Ig), UDCA significantly improved IgA (SMD=-0.02, 95%CI [-0.28, 0.25], P=0.013), but had no significant effects on IgG (SMD=-0.17, 95%CI [-0.44, 0.09], P=0.399) and IgM (SMD=0.16, 95%CI [-0.11, 0.42], P=0.715). Conclusion UDCA can significantly improve the liver function indexes in PSC patients, but has no significant effects on the immunological indexes.

Key words: Ursodeoxycholic acid, Primary sclerosing cholangitis, Liver function, Immunoglobulin

摘要: 目的 基于循证药学方法系统评价熊去氧胆酸(ursodesoxycholic acid,UDCA)对原发性硬化性胆管炎(primary sclerosing cholangitis,PSC)的疗效。方法 纳入国内外有关UDCA治疗PSC的试验,根据标准进行筛选,提取满足条件的高质量文献,采用Q检验及I2检验对纳入研究进行质量评价,用Stata 13.0进行分析。检索文献截止时间限定至2019年5月30日。结果 纳入5篇文献,共364例患者。与安慰剂组相比,UDCA组肝功能指标[碱性磷酸酶(ALP)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、白蛋白(ALB)和总胆红素(TBIL)]得到明显改善(SMD=-0.43,95%CI -0.65~-0.22,P<0.001;SMD=-0.90,95%CI -1.24~-0.56,P<0.001;SMD=-0.01,95%CI -0.28~0.27,P<0.001;SMD=0.00,95%CI -0.20~0.21,P<0.001;SMD=-0.31,95%CI -0.52~-0.10,P=0.001)。在免疫球蛋白(Ig)方面,UDCA能显著改善IgA(SMD=-0.02,95%CI -0.28~0.25,P=0.013),但对IgG(SMD=-0.17,95%CI -0.44~0.09,P=0.399)和IgM(SMD=0.16,95%CI -0.11~0.42,P=0.715)无明显影响。结论 UDCA可显著改善PSC患者肝功能指标,但对免疫学相关指标无明显影响。

关键词: 熊去氧胆酸, 原发性硬化性胆管炎, 肝功能, 免疫球蛋白