A meta-analysis of low molecular weight heparin in treatment of patients with severe community-acquired pneumonia / 中国感染与化疗杂志

ABSTRACT

Objective To evaluate the clinical efficacy of low molecular weight heparin in treatment of patients with severe community-acquired pneumonia (CAP).Methods PubMed, BMA, EMbase, ASP, Cochrane Library, EMCC, CBM, CNKI, CECDB, CQVIP, and VIP databases were searched to identify the relevant randomized clinical trials (RCTs) from the publications during the period from January 1994 to January 2014. The search terms were “low molecular heparin”, “severe community-acquired pneumonia”, “prognosis” in both Chinese and English. The quality of the included studies were strictly evaluated and data were extracted. Stata/SE version 12 software was used for systematic review and meta-analysis.Results Six RCTs were ifnally qualiifed in the analysis, including a total of 208 cases in treatment group and 196 cases in control group. The patients in control group received conventional therapy, while the patients in treatment group received low molecular weight heparin by subcutaneous injection as add-on to conventional therapy. Meta-analysis showed that after treatment with low molecular weight heparin for 7 days, the APACHE II score of severe CAP patients signiifcantly decreased (P = 0.43,I2 = 0%, SMD = -0.70, 95%CI - 0.90, -0.49) with controllable publication bias (bias_p = 0.93, bias_95CI -6.79, 6.37). The PaO2 of severe CAP patients signiifcantly increased (P = 0.858,I2 =0%, SMD = 0.51, 95%CI 0.30, 0.72) with controllable publication bias (bias_p =0.770, bias_95CI -4.82, 5.90). However, after low molecular weight heparin treatment for 7 days, the PaCO2 of severe CAP patients did not change significantly (SMD = -0.17, 95 %CI -0.38, 0.04).Conclusion Low molecular weight heparin is beneifcial in the treatment of severe CAP patients in terms of signiifcantly decreased APACHE II score, increased oxygenation, and improved clinical symptoms.