摘要
目的综合评价有机硒对地方性砷中毒患者的治疗效果,为今后进行地方性砷中毒的药物预防与干预提供科学依据。方法计算机检索万方数据库、维普数据库(VIP)、中国知网数据库(CNKI)、Pub Med、EBSCO、OVID,Springer、Sciencedirect,并结合文献追溯的方法,收集1994~2012年在国内外发表的关于我国地方性砷中毒药物干预的随机对照研究,包括自身对照、空白对照、及相互对照试验,以人体平均尿砷及血砷浓度为结局指标,干预手段为补充人体有机硒。选择符合纳入标准的临床试验,评价其方法学质量,并从中获取患者基本情况、干预措施、终点指标和结果等相关资料进行Meta分析。结果本研究共纳入9篇文献,合计664例患者纳入研究,采用Jadad量表对文献进行质量评价,纳入试验2项为低质量,7项为高质量。Meta分析结果显示:平均尿砷浓度WMD为-18.90(95%CI为-27.96^-9.85);平均血砷浓度WMD为-10.75(95%CI为-23.05~1.56);补硒干预可有效降低尿液及血清中砷离子的浓度。结论补充有机硒干预可降低尿液和血清中砷离子浓度,对砷中毒患者具有一定的排砷作用。但纳入研究的9项试验总样本量小,降低了这一结论的可靠性。开展高质量、内在真实性好的相关随机对照试验非常必要。
Objective In order to systematically evaluate the efficacy of organic selenium in treatment of patients with endemic arsenic poisoning,and to provide the reference for taking drug for prevention and intervention in the field of endemic arsenic poisoning. Methods The database including WANFANG,VIP,CNIK,Pub Med,EBSCO,OIVD,Springer,Sciencedirect,combined with the method of literature survey,and randomly collected controlled studies on drug intervention for endemic arsenic poisoning by taking selenium,and these studies were published in domestic and foreign references during 1994 to 2012. Its control experiments,blank control experiment met the need for control experiments.The clinical trials conformed to the joining standard,taking ＂ As in urine＂ and ＂ As in serum＂ as the indicators and their methodological quality had been evaluated,the basic situation of patients,intervention and relevant data about the ending indicators and results for making systematically evaluation had been taken. Results This study included 9 studies containing 664 patients. The quality of study had been evaluated by ＂ Jadad＂ scale,which found that the quality of 2 was low and 7 of them were high. The result of Meta analysis showed that： WMD of the average of ＂ As in urine＂ was- 18. 90（ 95% CI- 27. 96 ^- 9. 85）,and WMD of the average of ＂ As in serum＂ was- 10. 75（ 95% CI- 23. 05 ~ 1. 56）. Conclusion The supplementation of organic selenium can reduce the concentration of As in urine and serum. So organic selenium has the effect of discharging arsenic,but these 9 studies have insufficient sample size,thus it may reduce the reliability of conclusion. So it is necessary to carry out more good and reliable experiments.
出处
《临床和实验医学杂志》
2015年第7期538-542,共5页
Journal of Clinical and Experimental Medicine
基金
贵州省卫生厅项目(gzwkj2013-1-067)
项目名称:地方性砷中毒防控干预措施及效果的系统评价
关键词
地方性砷中毒
有机硒
系统评价
Endemic arsenic poisoning
Organic selenium
System evaluation
