特拉匹韦治疗基因1型慢性丙型病毒性肝炎疗效及安全性的Meta分析

发布时间：2018-09-04 10:02

【摘要】：目的：系统评价特拉匹韦联合聚乙二醇干扰素及利巴韦林治疗慢性丙型病毒性肝炎感染的疗效及安全性。方法：计算机全面检索PubMed.EMBASE及Cochrane图书馆中公开发表的,关于特拉匹韦联合聚乙二醇干扰素及利巴韦林,对比聚乙二醇干扰素联合利巴韦林治疗基因1型慢性丙型病毒性肝炎感染疗效及安全性比较的随机对照研究,所有检索截止日期为2012年11月。对符合纳入标准的文献采用RevMan5.2软件进行Meta分析。主要结局指标为持续病毒学应答率(SVR)、不良反应事件发生率,次要结局指标为复发率。结果：共纳入6个随机对照研究,患者总数2965例。Meta分析结果显示：无论初治或既往治疗失败再治疗患者,联合特拉匹韦的三联治疗方案均能显著提高持续病毒学应答率(初治患者：69.3%比44.4%,RR1.56,95%CI1.42-1.72:再治疗患者：61.3%比15.4%,RR3.84,95%CI2.85-5.18),基于种族、基线病毒载量和肝硬化背景的亚组分析显示了相似的结果；而且,三联治疗方案还显示出了较低的复发率(初治患者：11.6%比26.8%,RR0.50,95%CI0.28-0.90:再治疗患者：15.4%比57.3%,RR0.29,95%CI0.15-0.57)；与此同时三联治疗方案显示出了较高的皮疹(36.9%比21.6%,RR1.69,95%CI1.23-2.32)和贫血(41.6%比25.9%, RR1.62,95%CI1.32-1.99)的发生率,因不良反应事件导致停药的发生率也较标准二联治疗方案高(13.0%比7.6%, RR1.74,95%CI1.08-2.81). 结论：特拉匹韦联合聚乙二醇干扰素及利巴韦林能显著增加基因1型慢性丙型病毒性肝炎初治及治疗失败再治疗患者的持续病毒学应答率,同时减少复发率。但是增加了皮疹、贫血及因不良反应事件导致停药的发生率。
[Abstract]:Objective: to evaluate the efficacy and safety of trapevir combined with pegylated interferon and ribavirin in the treatment of chronic hepatitis C infection. Methods: a comprehensive computer search was carried out in the libraries of PubMed.EMBASE and Cochrane on the combination of trapivir and pegyleneglycol interferon and ribavirin. The efficacy and safety of pegylated interferon and ribavirin in the treatment of chronic hepatitis C infection with gene type 1 were compared in a randomized controlled trial. RevMan5.2 software was used to carry out Meta analysis for the literature that met the inclusion criteria. The main outcome index was persistent virological response rate (SVR),) and secondary outcome index was recurrence rate. Results: a total of 2965 patients were enrolled in 6 randomized controlled trials. Meta-analysis results showed that: no matter the first treatment or failure of previous treatment patients, Triple regimens combined with Trapivir significantly improved the rate of persistent virological response (initial patient: 69.3% vs 44.4g / RR1.56N 95CI1.42-1.72; retreated patient: 61.3% vs 15.4G RR3.84-95CI2.85-5.18). Subgroup analysis based on race, baseline viral load and background of cirrhosis showed similar results. Moreover, the triple regimen also showed a lower recurrence rate (first patient: 11.6% vs 26.8R 0.5095 CI0.28-0.90: retreated patient: 15.4% vs 57.3RR0.2995CI0.15-0.57); at the same time, the triple regimen showed a higher incidence of rashes (36.9% vs 21.6R1.69 / 95CI1.23-2.32) and anemia (41.6% vs 25.9CI1.2.32) and anemia (41.6% vs 25.9C, RR1.62,95%CI1.32-1.99). The incidence of withdrawal due to adverse events was also higher than that of standard combination therapy (13.0% vs 7.6, RR1.74,95%CI1.08-2.81). Conclusion: Trapivir combined with pegylated interferon and ribavirin can significantly increase the persistent virological response rate and reduce the recurrence rate of patients with chronic hepatitis C virus type 1 after initial treatment and failed retreatment. But it increases the incidence of rash, anemia, and withdrawal due to adverse events.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.63

【共引文献】