Abstract：
Modulation of the gut microbiome could favorably alter the hepatic venous pressure gradient (HVPG) in cirrhosis and portal hypertension (PH).
This meta-analysis was to evaluate the effects of microbiome-targeted therapies (MTTs) on HVPG in persons with cirrhosis and PH.
PubMed, The Cochrane Library, Embase, Web of Science and Scopus were searched for randomized clinical trials (RCTs) analyzing the effects on HVPG in people with cirrhosis who received MTTs. Clinical outcomes were pooled using RevMan5.3 software. A trial sequential analysis was applied to calculate the required information size and evaluate the credibility of the meta-analysis results.
A total of six studies were included. MTTs were associated with a reduction of 1.22 mm Hg in HVPG (95% CI: -2.31, -0.14 mmHg, P = 0.03). Subgroup analysis showed a greater reduction with longer duration (-1.88 mmHg;95% CI: -3.23, -0.53; P = 0.006). In the trial sequential analysis of HVPG reduction, the cumulative Z curve crossed the traditional significance boundary without the achievement of required information size (330).
MTTs may be associated with a reduction in HVPG in patients with cirrhosis and PH. Microbiome-targeted therapies merit additional large-sample studies to define the efficacy of HVPG.
PROSPERO 2020: CRD4202021609.
This meta-analysis was to evaluate the effects of microbiome-targeted therapies (MTTs) on HVPG in persons with cirrhosis and PH.
PubMed, The Cochrane Library, Embase, Web of Science and Scopus were searched for randomized clinical trials (RCTs) analyzing the effects on HVPG in people with cirrhosis who received MTTs. Clinical outcomes were pooled using RevMan5.3 software. A trial sequential analysis was applied to calculate the required information size and evaluate the credibility of the meta-analysis results.
A total of six studies were included. MTTs were associated with a reduction of 1.22 mm Hg in HVPG (95% CI: -2.31, -0.14 mmHg, P = 0.03). Subgroup analysis showed a greater reduction with longer duration (-1.88 mmHg;95% CI: -3.23, -0.53; P = 0.006). In the trial sequential analysis of HVPG reduction, the cumulative Z curve crossed the traditional significance boundary without the achievement of required information size (330).
MTTs may be associated with a reduction in HVPG in patients with cirrhosis and PH. Microbiome-targeted therapies merit additional large-sample studies to define the efficacy of HVPG.
PROSPERO 2020: CRD4202021609.
摘要：
肠道微生物组的调节可以有利地改变肝硬化和门静脉高压症（PH）中的肝静脉压力梯度（HVPG）。
这项荟萃分析旨在评估微生物组靶向治疗（MTT）对肝硬化和PH患者HVPG的影响。
PubMed,科克伦图书馆,Embase,搜索WebofScience和Scopus的随机临床试验（RCT），分析接受MTT的肝硬化患者对HVPG的影响。使用RevMan5.3软件汇集临床结果。应用试验序贯分析来计算所需的信息大小并评估荟萃分析结果的可信度。
共纳入6项研究。MTT与HVPG中1.22mmHg的降低相关(95%CI:-2.31,-0.14mmHg,P=0.03)。亚组分析显示，随着持续时间的延长，下降幅度更大（-1.88mmHg;95％CI：-3.23，-0.53;P=0.006）。在HVPG还原的试验顺序分析中，累积Z曲线越过传统的显著性边界而没有实现所需的信息大小(330)。
MTT可能与肝硬化和PH患者的HVPG降低有关。微生物组靶向治疗值得额外的大样本研究来定义HVPG的功效。
PROSPERO2020：CRD4202021609。
这项荟萃分析旨在评估微生物组靶向治疗（MTT）对肝硬化和PH患者HVPG的影响。
PubMed,科克伦图书馆,Embase,搜索WebofScience和Scopus的随机临床试验（RCT），分析接受MTT的肝硬化患者对HVPG的影响。使用RevMan5.3软件汇集临床结果。应用试验序贯分析来计算所需的信息大小并评估荟萃分析结果的可信度。
共纳入6项研究。MTT与HVPG中1.22mmHg的降低相关(95%CI:-2.31,-0.14mmHg,P=0.03)。亚组分析显示，随着持续时间的延长，下降幅度更大（-1.88mmHg;95％CI：-3.23，-0.53;P=0.006）。在HVPG还原的试验顺序分析中，累积Z曲线越过传统的显著性边界而没有实现所需的信息大小(330)。
MTT可能与肝硬化和PH患者的HVPG降低有关。微生物组靶向治疗值得额外的大样本研究来定义HVPG的功效。
PROSPERO2020：CRD4202021609。
