| Objective To systematically evaluate the effects of ulinastatin(UTI) inpatients with acute lung injury(ALI) or acute respiratory distresssyndrome(ARDS).Methods We searched the PubMed(1966～2011.3),the CochraneLibrary(Issue6,2011), EMbase（1974～2011）,CBM(1978～2011.3),CNKI（1915～2011.3）,VIP（1989～2011.3） and Wanfang Data（1982～2011.3）.Related published and unpublished data and attached references werehand searched. All randomized controlled trials (RCTs) of the effect of UTI onALL/ARDS were included. Study selection data extract and quality assessmentof included trials were undertaken by two independent reviewers according tothe Cochrane Reviewer’s Handbook. Meta-analyses was conducted by usingRevMan5.1software.Results19RCTs involving1193patients met the inclusion criteria. Theresults of meta-analyses showed that there was a statistically significantimprovement in oxygenation at diffent times of3,4,5and7days after thetreatment of UTI, expressed as the oxygenation index and the partial pressure ofoxygen. Acute physiology and chronic health evaluation(APACHEⅡ) score at7 day in ulinastatin group was significantly lower than the control group. Durationof ventilation/the time of intubation and length of stay in the intensive care unitwere sifnificantly lower with UTI use. We also found a statistically significantreduction on the incidence of ARDS and mortality.Conclusions The current evidence shows that UTI could improvepulmonary function and prognosis of patients with ALL/ARDS. However, it isfar from enough to recommend UTI as a conventional adjuvant therapy forALL/ARDS because of no sufficient evidence obtained from this study for itssmall sample and low quality. Therefore, more RCTs with large sample,multi-center and high quality are required for further verification. |
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