奥美拉唑预防卒中后应激性溃疡出血疗效的Meta分析 Preventive Effects of Omeprazole Against Stress Ulcer Bleeding for Post-stroke Patients: A Meta Analysis

Abstract

目的 系统评价奥美拉唑预防卒中后患者应激性溃疡出血（stress ulceration and bleeding，SUB）的疗效， 及其与H2受体阻滞剂（histamine-2 receptor antagonists，H2RA）疗效的对比。 方法 计算机检索Cochrane、PubMed、Embase、CNKI、WanFang和VIP。纳入奥美拉唑预防卒中后SUB的随 机对照试验，对纳入的研究采用RevMan 5.2软件进行Meta分析。 结果 共纳入17个随机对照试验（1739例患者）。Meta分析结果显示：预防性使用奥美拉唑能降低 卒中后SUB的发生率[比值比（odds ratio，OR）0.1，95%可信区间（confidence interval，CI）0.06～0.14，P ＜0.00001]；奥美拉唑降低卒中后患者SUB的发生率效果优于H2RA（OR 0.24，95%CI 0.15～0.38，P ＜0.00001）；奥美拉唑可降低卒中后患者的病死率（OR 0.17，95%CI 0.09～0.33，P＜0.00001）。 结论 现有证据表明，预防性使用奥美拉唑，能降低卒中后患者SUB的发生率与病死率，且其效果 优于H2RA。 Abstract: Objective To evaluate the preventive effects of omeprazole against stress ulcer bleeding (USB) for post-stroke patients, and compare their effectiveness between Histamine-2 receptor antagonists (H2RA). Methods Cochrane, PudMed, Embase, CNKI, WangFang and VIP were searched systematically. Case-control studies of omeprazole protects against SUB for post stroke patients were included, and the articles were performed Meta analysis by RevMan 5.2 software. Results A total of 17 case-control studies (1739 cases) were included. The results of meta-analysis were as followed: Prophylactic use of omeprazole could decrease the incidence of SUB for post-stoke patients [odds ratio (OR) 0.01, 95% confidence interval (CI) 0.06-0.14, P <0.00001]; and the treatment effectives of USB with omeprazole was better than H2RA (OR 0.24, 95%CI 0.15-0.38, P <0.00001). The use of omeprazole could decrease the mortality of post-stroke patients (OR 0.17, 95%CI 0.09-0.33, P <0.0001). Conclusion Evidence indicates that prophylactic use of omeprazole can decrease the incidence of SUB and mortality among post-stoke patients, and the effectiveness is better than H2RA.

Keywords

• 奥美拉唑
• 卒中
• 应激性溃疡出血
• h2受体阻滞剂
• meta分析
• omeprazole
• stroke
• stress ulcer bleeding
• h2 receptor antagonist
• meta analysis