Terlipressin Plus Albumin In The Treatment Of Type 1 Hepatorenal Syndrome: A Meta Analysis

Objective: to assess the efficacy and safety of terlipressin plus albumin on the treatment of Type 1 hepatorenal syndrome(HRS),To provide evidence for clinical treatment of hepatorenal syndrome.Method: Cochrane strategy was used to identify the previously published randomized controlled trials,before July 2016,by searching PubMed,The Cochrane Library,Web of Science and LILACS,Medline,Embase,Chinese Biomedical Literature Database(CBM),Chongqing VIP Information Co,Ltd,China National Knowledge Internet Database,Wanfang Data.Collect all the literature that use of terlipressin combined with albumin in patients with type 1 hepatorenal syndrome(HRS),two researchers independently screened literature and extracted data according to the inclusion and exclusion criteria.Use RevMan 5.3 provided by the Cochrane collaboration to meta-analysis.Results:1.Search Results In all the databases,we initially identified 693 articles of which 6 articles were included in the meta-analysis after screening,All of them were randomized controlled trials.There were 2 studies comparing terlipressin plus albumin with placebo,and 1 study comparing terlipressin plus albumin with distilled water,3 studies for terlipressin plus albumin with albumin alone.The general quality of the studies are of high standard.2.The results of Meta analysis 6 randomized controlled trials,542 cases were selected for this Meta analysis,which showed that the Type 1 HRS remission rate and the survival rate were increased by the terlipressin plus albumin,with(OR:4.25,95% CI:2.77-6.52,p?0.0001);and(OR: 2.33,95% CI: 1.11-4.88,P=0.03),respectively,Blood creatinine was decreased by terlipressin,with(OR:2.33,95% CI: 1.11-4.88,P=0.03)and mean arterial pressure was increased significantly,with(SWD=0.92,95% CI:0.01-0.76,P=0.0005),while there was no difference in urine output(SWD=8.30,95% CI:-3.93-20.54,P=0.18).Side effects due to the systemic circulation congestion and peripheral vasoconstriction were reported,such as non fatal myocardial infarction,non persistent aventricular tachycardia,dyspnea,spiratory acidosis,arrhythmia,atrial fibrillation,chest pain,abdominal pain,peripheral vascular spasm,etc.Nofatal side effect was reported.Conclusion: Terlipressin plus albumin to improve type I hepatorenal syndrome(HRS)is an ideal treatment method because of its good curative effect,less adverse reaction and good security.