Efficacy of glutamine enriched nutrition support for patients with severe acute pancreatitis: a Meta analysis / 中华消化外科杂志

ABSTRACT

Objective To systematically review the efficacy of glutamine enriched nutrition support for patients with severe acute pancreatitis (SAP).Methods Database including PubMed,Embase,HighWire,Cochrane Central Register of Controlled Trials,Wanfang Database,CJFD and CBM were searched with glutamine,severe acute pancreatitis,SAP,谷氨酰胺,重症急性胰腺炎.Literatures published before March 2014 were searched.Randomized controlled trials containing the comparison of conventional treatment and glutamine enriched nutrition support were enrolled in the study,and then the literatures were screened and the data were extracted by 2 independent reviewers.The quality of the literatures was assessed,and the data were analyzed using the RevMan 5.2 software.SAP was diagnosed according to The revised Atlanta classificantion for acute pancreatitis or guideline for the diagnosis and treatment of SAP which was composed by the pancreatic surgery Branch of Chinese Medical Association.The count data were analyzed using the relative risk (RR) and 95％ confidence interval (95％ CI),and the measurement data were analyzed using standard mean difference (SMD) and 95 ％ CI.The heterogeneity of the data was analyzed using the I2 test.Results Ten literatures including 433 cases were enrolled in the study,and all of them were prospective randomized controlled studies.There were 218 patients treated by conventional methods (control group) and 215 patients received glutamine enriched nutrition support (experimental group).Compared with the control group,glutamine enriched nutrition support could elevate the albumin level,decrease the C-reaction protein level and shorten the hospital stay in the experimental group (SMD=1.00,-0.93,-0.71,95％CI0.50-1.50,-1.25--0.61,-1.10--0.32,P＜0.05),glutamine enriched nutrition support could decrease the morbidity and mortality (RR =0.56,0.34,95％ CI0.41-0.77,0.15-0.76,P ＜ 0.05) without increasing the expenses (SMD =0.03,95％ CI-0.88-0.95,P ＞ 0.05).Conclusion Glutamine enriched nutrition support is superior to conventional methods for the treatment of SAP.