Efficacy of glucocorticoids in treatment of severe hepatitis : a Meta-analysis / 中华临床感染病杂志

ABSTRACT

Objective To evaluate the clinical efficiency of glucocorticoids in treatment of severe hepatitis.Methods A systematic review on the efficacy of glucocorticoids in treatment of severe hepatitis was conducted.Relevant literatures were searched in PubMed (1966-2011),EMCC (1995-2011),Springer,CNKI,Wanfang Database and CBM.The retrieved literatures were screened according to the predefined inclusion and exclusion criteria.RevMan 5.0 statistical software was used for Meta-analysis.The mortality was evaluated by relative risk (RR),while the total bilirubin (TBil),ALT and prothrombin activity (PTA) were evaluated by weighted mean difference (WMD) and 95％ confidential interval (CI).The publication bias and sensitivity about the data were measured by forest plot and funnel plot.Results Twenty-three papers involving a total of 1457 patients were included in the study.Compared to control group,the mortality in glucocorticoids-treated group was lower (RR =0.39,95％ CI0.32-0.47,Z =9.75,P＜0.01); and the TBil (WMD=-88.03,95％CI-112.80-63.26,Z=6.97,P＜0.01),ALT (WMD=-25.04,95％CI-42.23-7.84,Z=2.85,P＜0.01) and PTA levels (WMD=21.56,95％ CI6.52-36.60,Z=2.81,P ＜0.01) in glucocorticoids-treated group were improved.Conclusion Glucocorticoids can effectively improve TBil,ALT and PTA levels,and reduce the mortality of patients with severe hepatitis.