目的 汇总分析肝硬化患者消化道出血风险预测模型,为今后模型的建立和优化提供参考。方法 系统检索中国知网、维普、PubMed数据库在2025年4月22日前公开发表的所有肝硬化患者消化道出血风险预测模型,按纳入标准筛选文献,对最终纳入文章分析摘录并系统汇总,包括模型特征、危险因素及模型预测评估效果等信息。结果 共检索3 603篇预测模型相关研究论文,最终纳入30篇,其中中国27篇、韩国1篇、印度1篇、埃及1篇。22项研究收集了肝硬化病因,其中病毒性肝病最多(72.94%,2 922/4 006),药物性肝病及非酒精性脂肪性肝病最少(均为0.02%,1/4 006)。在研究类型上,有28篇单中心研究,2篇为多中心研究,其中有12个模型未进行验证,只有1个模型进行了外部验证,其余模型只进行了内部验证,曲线下面积(AUC)范围0.680~0.994。根据模型纳入因素特点,分为血常规指标、凝血指标、生化指标、影像学指标、复合指标、其他指标共6种,其中纳入因素最多为影像学指标,最少为凝血指标。在纳入危险因素中,第1位为门静脉直径,第2位为血小板计数,第3位为血红蛋白水平及脾脏硬度,所有因素中与脾脏相关的指标最多。结论 肝硬化患者消化道出血风险预测模型研究质量有待提升,影像学指标应用最广,脾脏相关指标重要性突出,门静脉直径、血小板计数、血红蛋白水平及脾脏硬度为最常用的危险预测因素。
Objective To summarize and analyze the prediction models for gastrointestinal bleeding risk in patients with cirrhosis,providing references for the establishment and optimization of future models.Methods A systematic search was conducted in CNKI,VIP,and PubMed for all published prediction models for gastrointestinal bleeding risk in patients with cirrhosis before April 22,2025.Articles were screened according to the inclusion criteria,and the finally included articles were analyzed and summarized,including model characteristics,risk factors,and model prediction evaluation effects.Results A total of 3 603 related research papers on prediction models were initially retrieved,and 30 were finally included,with 27 from China,one from South Korea,one from India,and one from Egypt.Among the 22 studies that collected the etiology of cirrhosis,viral hepatitis was the most common(72.94%,2 922/4 006),while drug-induced liver disease and non-alcoholic fatty liver disease were the least common(0.02%,1/4 006).In terms of study type,28 were single-center studies and two were multicenter studies.Among them,12 models were not validated,only one model was externally validated,and the rest were only internally validated,with an area under the curve range of 0.680-0.994.According to the characteristics of the factors included in the models,they were divided into six types of indicators:blood routine,coagulation,biochemistry,imaging,composite,and others,among which imaging indicators were the most common and coagulation indicators were the least.In the included risk factors,the first was portal vein diameter,the second was platelets count,and the third was hemoglobin level and spleen stiffness,with the most factors related to the spleen.Conclusions The quality of studies on prediction models for gastrointestinal bleeding risk in cirrhosis patients needs to be improved.Imaging indicators are the most widely used,and spleen-related indicators are of prominent importance,with portal vein diameter,platelets count,hemoglobin level,and spleen stiffness being the most commonly used risk prediction factors.
目的 系统评价心脉通治疗冠心病的临床疗效及其安全性。方法 2名研究者独立系统地检索心脉通治疗冠心病的文献,其中包括维普中文科技期刊全文数据库(VIP)、PubMed 电子期刊全文数据库、中国学术期刊全文数据库(CNKI)、The Cochrane Library 数据库、万方数据库等6个数据库。同时运用Review Manager 5.4 软件进行本研究的数据处理。结果 最终共纳入8篇文献,共计985名心脉通治疗冠心病患者。治疗前后的临床疗效、发作频率、血脂水平的Meta分析结果显示心脉通组优于常规治疗组。有3项纳入试验报告不良反应。结论 心脉通治疗冠心病的临床疗效优于常规治疗。心脉通不仅可以降低冠心病发作频率,缩短其发作持续时间,还能调节血脂水平,在治疗冠心病方面疗效确切,值得临床参考应用。
Objective To systematically evaluate the clinical efficacy and safety of Xinmaitong in the treatment of coronary heart disease (CHD). Methods Two researchers searched the literatures of Xinmaitong in the treatment of coronary heart disease independently and systematically, including VIP Chinese Sci-tech Journal full-text Database (VIP), PubMed Electronic Journal full-text Database, Chinese Academic Journal full-text Database (CNKI), The Cochrane Library Database and Wanfang Database. At the same time, Review Manager 5.4 software was used to process the data of this study. Results A total of 8 articles were included, and a total of 985 patients with coronary heart disease were treated with Xinmaitong. The results of Meta analysis of clinical efficacy, attack frequency and blood lipids level before and after treatment showed that Xinmaitong group was better than routine treatment group. Three items were included in the report of adverse reactions. Conclusions The clinical effect of Xinmaitong in the treatment of coronary heart disease was better than that of routine treatment. Xinmaitong can not only reduce the frequency and duration of coronary heart disease attack, but also regulate blood lipids level. Xinmaitong was effective in the treatment of coronary heart disease and is worthy of clinical reference.