目的 :对普萘洛尔能否预防肝硬化并发上消化道出血进行系统评价。方法 :检索 1 980年 1月至 2 0 0 0年 1 2月期间发表的有关普萘洛尔预防肝硬化并发上消化道出血的随机对照临床试验。按照入选标准 ,有 9项临床试验纳入本研究。结果 :上消化道再出血和因出血死亡的合并优势比 (OR)分别为0 .3 0 [95 %CI 0 .2 2 ,0 .42 ],0 .43 [95 %CI 0 .2 3 ,0 .84],P <0 .0 5 ;而死亡的OR为 0 .67[95 %CI0 .44,1 .0 4],P >0 .0 5。肝功能越差 ,预防效果越好。结论 :普萘洛尔可以预防肝硬化并发上消化道再出血 ,并可降低再出血所致的死亡率。肝功能的状况是影响普萘洛尔的预防效果的重要因素 Objective: To evaluate whether propranolol can prevent cirrhosis complicated by upper gastrointestinal bleeding. METHODS: A randomized controlled clinical trial of propranolol in the prevention of cirrhosis complicated by upper gastrointestinal bleeding was published from January 1980 to January 2010. According to the inclusion criteria, nine clinical trials were included in this study. RESULTS: The odds ratios for upper gastrointestinal rebleeding and bleeding death were 0.30 [95% CI 0.22, 0.42], 0.43 [95% CI 0.23, 0 .84], P <0. 05; and death OR was 0.67 [95% CI0 .44,1 .0 4], P> 0. The worse the liver function, the better the prevention effect. Conclusion: Propranolol can prevent cirrhosis with upper gastrointestinal rebleeding and reduce the mortality caused by rebleeding. The condition of liver function is an important factor that affects the prophylactic effect of propranolol