Systematic Review of Therapeutic Efficacy of Ulinastatin for Domestic Sepsis in China

OBJECTIVE:To evaluate therapeutic efficacy of ulinastatin in the treatment of sepsis in china.METHODS:Retrieved from CNKI,CBM,VIP and Wanfang database,randomized controlled trials(RCT)and quasi-randomized controlled trials(quasi-RCT)of ulinastatin in the treatment of sepsis were searched.The references were also searched.The methodological quality of included studies was estimated,and Rev Man 5.0 software was used for data analysis.RESULTS:28 RCT were included,involving 1 615 patients.Meta-analysis showed 28-day mortality [RR=0.55,95%CI(0.41,0.73),P0.05],mortality during observation period [RR=0.51,95%CI(0.37,0.70),P0.05],hospitalization days in ICU [WMD=-5.75,95%CI(-6.59,-4.91),P0.05],average hospitalization days [WMD=-5.00,95%CI(-10.24,0.24),P=0.06] and the incidence of multiple organ dysfunction [RR= 0.53,95%CI(0.31,0.90),P=0.02] of treatment group were all lower than control group.The improvement of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score [WMD=-5.19,95%CI(-5.71,-4.66),P0.05] in treatment group was better than in control group.CONCLUSIONS:Ulinastatin can decrease the 28-day mortality,the mortality during observation period,hospitalization days in hospital,the incidence of MODS,and improve APACHE Ⅱ score.However,because of the low methodological quality of included trials,high quality studies are needed to be performed to testify its therapeutic efficacy and safety.