Efficacy and safety of norepinephrine combined with albumin versus terlipressin combined with albumin in treatment of type 1 hepatorenal syndrome: A Meta-analysis
10.3969/j.issn.1001-5256.2019.10.027
- VernacularTitle:去甲肾上腺素或特利加压素联合白蛋白治疗1型肝肾综合征效果及安全性的比较Meta分析
- Author:
Yanxin QIN
1
;
Fuli LONG
;
Dewen MAO
Author Information
1. Guangxi University of Chinese Medicine, Nanning 530001, China
- Publication Type:Research Article
- Keywords:
hepatorenal syndrome;
norepinephrine;
terlipressin;
serum albumin;
Meta-analysis as topic
- From:
Journal of Clinical Hepatology
2019;35(10):2266-2271
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo systematically review the efficacy and safety of norepinephrine combined with albumin versus terlipressin combined with albumin in the treatment of type 1 hepatorenal syndrome (HRS1). MethodsPubMed, EMBASE, Medline, Cochrane Library, CNKI, Wanfang Data, and VIP were searched for comparative studies on norepinephrine combined with albumin versus terlipressin combined with albumin in the treatment of HRS1. Quality assessment was performed for articles. Related indicators were extracted, including hepatorenal syndrome (HRS) reversal rate, mortality rate, incidence of adverse events, mean arterial pressure, and renal function, and Review Manager 5.3 was used for data analysis. The chi-square test was used to determine the heterogeneity between studies. Odds ratio (OR) was used for the analysis of dichotomous variables, weighted mean difference (WMD) was used for the analysis of continuous variables, and 95% confidence interval (CI) was calculated for these two types of variables. ResultsA total of 6 randomized controlled trials which met the inclusion criteria were included, with a total sample size of 298 patients (149 patients in the norepinephrine+albumin group and 149 in the terlipressin+albumin group). The meta-analysis showed that there were no significant differences between the two groups in HRS reversal rate (OR=0.95, 95%CI: 0.6-1.49, P=0.81), mortality rate (OR=0.84, 95%CI: 0.51-1.41, P=0.51), incidence rate of adverse events (OR=042, 95%CI: 0.16-1.07, P=0.07), mean arterial pressure (standardized mean difference=0.05, 95%CI: -0.92 to 1.03, P=092), and renal function. ConclusionNorepinephrine combined with albumin has similar efficacy and safety as terlipressin combined with albumin in the treatment of HRS1, and terlipressin can be replaced by norepinephrine in clinical practice when necessary.
