PDF(Pubmed)
Abstract：
UNASSIGNED: The efficacy of neutrophil elastase inhibitor sivelestat in the treatment of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) remains controversial. A systematic review and meta-analysis were performed in accordance with the PRISMA guidelines assess the effect of sivelestat on ALI/ARDS patients, different studies were included.
UNASSIGNED: Electronic databases, National Knowledge Infrastructure (CNKI), Wan fang data, VIP, PubMed, Embase, Springer, Ovid and the Cochrane Library were searched using the following key words: (\"Sivelestat\" OR \"Elaspol\") AND (\"ARDS\" OR \"adult respiratory distress syndrome\" OR \"acute lung injury\"). All databases published from January 2000 to August 2022. The treatment group was treated with sivelestat and the control group was given normal saline. The outcome measurements include the mortality of 28-30 days, mechanical ventilation time, ventilation free days, intensive care unit (ICU) stays, oxygenation index (PaO2/FiO2) on day 3, the incidence of adverse events. The literature search was conducted independently by 2 researchers using standardized methods. We used the Cochrane risk-of-bias tool to assess the quality of the included studies. Mean difference (MD), Standardized mean difference (SMD) and relative risk (RR) were calculated using random effects model or fixed effects model. All statistical analyses were performed using RevMan software 5.4.
UNASSIGNED: A total of 2050 patients were enrolled in 15 studies, including 1069 patients in treatment group and 981 patients in the control group. The results of the meta-analysis showed that: compared with the control group, sivelestat can reduce the mortality of 28-30 days (RR = 0.81, 95% CI = 0.66-0.98, p = 0.03) and the incidence of adverse events (RR = 0.91, 95% CI = 0.85-0.98, p = 0.01), shortened mechanical ventilation time (SMD = - 0.32, 95% CI = - 0.60 to - 0.04, p = 0.02) and ICU stays (SMD = - 0.72, 95% CI = - 0.92 to - 0.52, p < 0.00001), increased the ventilation free days (MD = 3.57, 95% CI = 3.42-3.73, p < 0.00001) and improve oxygenation index (PaO2/FiO2) on day 3 (SMD = 0.88, 95% CI = 0.39-1.36, p = 0.0004).
UNASSIGNED: Sivelestat can not only reduce the mortality of ALI/ARDS patients within 28-30 days and the incidence of adverse events, shorten the mechanical ventilation time and ICU stays, increase ventilation free days, but also improve the oxygenation index of patients on days 3, which has a good effect on the treatment of ALI/ARDS. These findings need to be verified in large-scale trials.
UNASSIGNED: Electronic databases, National Knowledge Infrastructure (CNKI), Wan fang data, VIP, PubMed, Embase, Springer, Ovid and the Cochrane Library were searched using the following key words: (\"Sivelestat\" OR \"Elaspol\") AND (\"ARDS\" OR \"adult respiratory distress syndrome\" OR \"acute lung injury\"). All databases published from January 2000 to August 2022. The treatment group was treated with sivelestat and the control group was given normal saline. The outcome measurements include the mortality of 28-30 days, mechanical ventilation time, ventilation free days, intensive care unit (ICU) stays, oxygenation index (PaO2/FiO2) on day 3, the incidence of adverse events. The literature search was conducted independently by 2 researchers using standardized methods. We used the Cochrane risk-of-bias tool to assess the quality of the included studies. Mean difference (MD), Standardized mean difference (SMD) and relative risk (RR) were calculated using random effects model or fixed effects model. All statistical analyses were performed using RevMan software 5.4.
UNASSIGNED: A total of 2050 patients were enrolled in 15 studies, including 1069 patients in treatment group and 981 patients in the control group. The results of the meta-analysis showed that: compared with the control group, sivelestat can reduce the mortality of 28-30 days (RR = 0.81, 95% CI = 0.66-0.98, p = 0.03) and the incidence of adverse events (RR = 0.91, 95% CI = 0.85-0.98, p = 0.01), shortened mechanical ventilation time (SMD = - 0.32, 95% CI = - 0.60 to - 0.04, p = 0.02) and ICU stays (SMD = - 0.72, 95% CI = - 0.92 to - 0.52, p < 0.00001), increased the ventilation free days (MD = 3.57, 95% CI = 3.42-3.73, p < 0.00001) and improve oxygenation index (PaO2/FiO2) on day 3 (SMD = 0.88, 95% CI = 0.39-1.36, p = 0.0004).
UNASSIGNED: Sivelestat can not only reduce the mortality of ALI/ARDS patients within 28-30 days and the incidence of adverse events, shorten the mechanical ventilation time and ICU stays, increase ventilation free days, but also improve the oxygenation index of patients on days 3, which has a good effect on the treatment of ALI/ARDS. These findings need to be verified in large-scale trials.
摘要：
■中性粒细胞弹性蛋白酶抑制剂西维司他治疗急性肺损伤（ALI）和急性呼吸窘迫综合征（ARDS）的疗效仍存在争议。根据PRISMA指南进行系统评价和荟萃分析，评估西维司他对ALI/ARDS患者的影响。包括不同的研究。
■电子数据库，国家知识基础设施(CNKI),万方数据,VIP,PubMed,Embase,Springer,使用以下关键字搜索Ovid和Cochrane图书馆：（\“Sivelestat\”或\“Elaspol\”）和（\“ARDS\”或\“成人呼吸窘迫综合征\”或\“急性肺损伤\”）。所有数据库于2000年1月至2022年8月发布。治疗组给予西维司他治疗,对照组给予生理盐水治疗。结果测量包括28-30天的死亡率，机械通气时间,免费通风天，重症监护病房(ICU)住院,第3天的氧合指数(PaO2/FiO2)、不良事件发生率。文献检索由2名研究者采用标准化方法独立进行。我们使用Cochrane偏倚风险工具来评估纳入研究的质量。平均差（MD），使用随机效应模型或固定效应模型计算标准化平均差（SMD）和相对风险（RR）。所有统计分析均使用RevMan软件5.4进行。
■共有2050名患者参加了15项研究，其中治疗组1069例,对照组981例。Meta分析结果显示:与对照组相比,西维司他可以降低28-30天的死亡率（RR=0.81，95％CI=0.66-0.98，p=0.03）和不良事件的发生率（RR=0.91，95％CI=0.85-0.98，p=0.01），缩短了机械通气时间（SMD=-0.32，95％CI=-0.60至-0.04，p=0.02）和ICU住院时间（SMD=-0.72，95％CI=-0.92至-0.52，p<0.00001），在第3天增加了无通气天数（MD=3.57，95％CI=3.42-3.73，p<0.00001）并改善了氧合指数（PaO2/FiO2）（SMD=0.88，95％CI=0.39-1.36，p=0.0004）。
■Sivelestat不仅可以降低ALI/ARDS患者在28-30天内的死亡率和不良事件的发生率，缩短机械通气时间和ICU住院时间，增加无通风天数，而且还能改善患者第3天的氧合指数，对ALI/ARDS的治疗有较好的效果。这些发现需要在大规模试验中得到验证。
■电子数据库，国家知识基础设施(CNKI),万方数据,VIP,PubMed,Embase,Springer,使用以下关键字搜索Ovid和Cochrane图书馆：（\“Sivelestat\”或\“Elaspol\”）和（\“ARDS\”或\“成人呼吸窘迫综合征\”或\“急性肺损伤\”）。所有数据库于2000年1月至2022年8月发布。治疗组给予西维司他治疗,对照组给予生理盐水治疗。结果测量包括28-30天的死亡率，机械通气时间,免费通风天，重症监护病房(ICU)住院,第3天的氧合指数(PaO2/FiO2)、不良事件发生率。文献检索由2名研究者采用标准化方法独立进行。我们使用Cochrane偏倚风险工具来评估纳入研究的质量。平均差（MD），使用随机效应模型或固定效应模型计算标准化平均差（SMD）和相对风险（RR）。所有统计分析均使用RevMan软件5.4进行。
■共有2050名患者参加了15项研究，其中治疗组1069例,对照组981例。Meta分析结果显示:与对照组相比,西维司他可以降低28-30天的死亡率（RR=0.81，95％CI=0.66-0.98，p=0.03）和不良事件的发生率（RR=0.91，95％CI=0.85-0.98，p=0.01），缩短了机械通气时间（SMD=-0.32，95％CI=-0.60至-0.04，p=0.02）和ICU住院时间（SMD=-0.72，95％CI=-0.92至-0.52，p<0.00001），在第3天增加了无通气天数（MD=3.57，95％CI=3.42-3.73，p<0.00001）并改善了氧合指数（PaO2/FiO2）（SMD=0.88，95％CI=0.39-1.36，p=0.0004）。
■Sivelestat不仅可以降低ALI/ARDS患者在28-30天内的死亡率和不良事件的发生率，缩短机械通气时间和ICU住院时间，增加无通风天数，而且还能改善患者第3天的氧合指数，对ALI/ARDS的治疗有较好的效果。这些发现需要在大规模试验中得到验证。
