【摘要】：目的評(píng)價(jià)強(qiáng)化胰島素治療對(duì)急性腦卒中伴應(yīng)激性高血糖患者醫(yī)院感染率的影響。方法計(jì)算機(jī)檢索PubMed、Embase、Cochrane Library、WanFang及CNKI Data數(shù)據(jù)庫,同時(shí)手工檢索相關(guān)專業(yè)雜志并追溯納入文獻(xiàn)的參考文獻(xiàn),按照統(tǒng)一的納入和排除標(biāo)準(zhǔn)選擇文獻(xiàn),系統(tǒng)評(píng)價(jià)強(qiáng)化胰島素治療急性腦卒中患者醫(yī)院感染發(fā)生率與平均血糖。結(jié)果納入13個(gè)隨機(jī)對(duì)照試驗(yàn)(RCT),共1 032例患者。Meta分析結(jié)果顯示,醫(yī)院感染率比較最終納入10個(gè)研究832例患者,強(qiáng)化組和常規(guī)組醫(yī)院感染率分別為28.3%和56.1%,Z=4.50,兩組差異有統(tǒng)計(jì)學(xué)意義[RR=0.53(95%CI:0.40~0.70),P0.001];血糖水平比較最終納入5個(gè)研究328例患者,兩組患者平均血糖差異有統(tǒng)計(jì)學(xué)意義[MD=-2.52(95%CI:-4.30~-0.74),P=0.006]。醫(yī)院感染率漏斗圖分析顯示存在發(fā)表性偏倚。結(jié)論強(qiáng)化胰島素治療用于急性腦卒中伴應(yīng)激性高血糖的調(diào)控,可降低醫(yī)院感染率和患者血糖。
[Abstract]:Objective to evaluate the effect of intensive insulin therapy on nosocomial infection rate in acute stroke patients with stress hyperglycemia. Methods the online database of PubMeden Embase Cochrane Library Wan Fang and CNKI data were searched by computer, and the relevant professional journals were retrieved by hand and the references included in the literature were traced back, and the literature was selected according to the unified inclusion and exclusion criteria. Systematic evaluation of the incidence of nosocomial infection and mean blood glucose in patients with acute stroke treated with intensive insulin. Results in 13 randomized controlled trials (RCT), a total of 1032 patients. Meta analysis showed that the nosocomial infection rate was included in 832 patients in 10 studies. The nosocomial infection rate of the two groups was 28.3% and 56.1%, respectively, and the difference between the two groups was statistically significant [RRV 0.53 (95 CI: 0.40 / 0.70) P 0.001], and the blood glucose level of the two groups was significantly higher than that of the control group (MD-2.52 (95CIW -4.30U -0.74) P0. 006). Nosocomial infection rate funnel analysis showed that there was a published bias. Conclusion intensive insulin therapy can reduce the nosocomial infection rate and blood glucose in patients with acute stroke and stress hyperglycemia.
【作者單位】： 上海市浦東新區(qū)浦南醫(yī)院;海鹽縣中醫(yī)院浙江省立同德醫(yī)院海鹽分院;浙江省立同德醫(yī)院;
【基金】：上海市衛(wèi)生和計(jì)劃生育委員會(huì)科研基金(201440472) 浦東新區(qū)科技發(fā)展創(chuàng)新基金(PKJ2014-Y27)
【分類號(hào)】：R743.3

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