The Efficacy and Immunomodulatory Effects of Ulinastatin and Thymosinα1 for Sepsis: A Systematic Review and Meta-Analysis

Autor: Jia Rong Zhong, Feng Yun Wang, Xin Hua Qiang, Tie Ou Yu, Jun Cao, Bin Fang, Li Xin Zhou
Rok vydání: 2016
Předmět:
Male
0301 basic medicine
Thymalfasin
medicine.medical_treatment
lcsh:Medicine
Comorbidity
Review Article
law.invention
chemistry.chemical_compound
0302 clinical medicine
Randomized controlled trial
Risk Factors
law
Prevalence
Randomized Controlled Trials as Topic
Aged
80 and over
General Medicine
Middle Aged
Causality
Survival Rate
Treatment Outcome
030220 oncology & carcinogenesis
Meta-analysis
Female
Respiratory Insufficiency
Adult
medicine.medical_specialty
General Biochemistry
Genetics and Molecular Biology
Sepsis
03 medical and health sciences
Internal medicine
medicine
Humans
Immunologic Factors
Survival rate
Aged
Glycoproteins
Mechanical ventilation
General Immunology and Microbiology
business.industry
lcsh:R
Odds ratio
Ulinastatin
medicine.disease
Respiration
Artificial
Surgery
Thymosin
Clinical trial
030104 developmental biology
chemistry
business
Zdroj: BioMed Research International, Vol 2016 (2016)
BioMed Research International
ISSN: 2314-6141
2314-6133
DOI: 10.1155/2016/9508493
Popis: Objective. To systematically review the efficacy and potential immunomodulatory effect of ulinastatin combined with thymosinα1 (UTI) for sepsis.Design. A systematic review and meta-analysis of randomized controlled trials (RCTs).Data Sources. The following databases: PubMed, Embase, and Cochrane Central were searched to identify related clinical trials. The search terms were “ulinastatin”, “thymosin”, and “sepsis”.Results. Six RCTs, 944 septic patients in total, were included in this meta-analysis. The result shows UTI increased the 28-day survival rate of septic patients, odds ratio (OR) = 2.01, 95% CI [1.53, 2.64]. After the treatment with UTI, the APACHE II score (four studies) dropped 4.72 further, mean = −4.72, 95% CI [−6.54, −2.91] (p<0.00001). The mean time of ICU stay (four studies) in UTI group decreased 3.03 days further, mean = −3.03 [−6.99, 0.95] (p=0.14), and mechanical ventilation time (four studies) decreased 2.05 days, mean = −1.81 [−2.96, −0.66] (p=0.002). With the treatment of UTI, CD4+T cells raised 5.13%, mean = 5.13, 95% CI [2.75, 7.50] (p<0.0001); there was no significant change in CD8+T cells, mean = −0.74 [−2.93, 1.45] (p=0.51).Conclusion. According to this meta-analysis, with the treatment of UTI, the short-term survival rate of septic patients was increased and the illness severity was alleviated. ICU stay and mechanical ventilation time were effectively shortened. The beneficial effect of UTI might be due to the potential immunomodulatory effects of these two drugs.
Databáze: OpenAIRE
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