两性霉素B、氟康唑和伊曲康唑治疗AIDS合并马尔尼菲青霉病疗效的Meta分析

发布时间：2018-11-09 09:22

【摘要】：目的采用Meta分析评价两性霉素B、氟康唑与伊曲康唑对AIDS合并马尔尼菲青霉病(penicilliosis marneffei,PSM)的治疗效果。方法检索Cochrane图书馆、美国国立医学图书馆Pub Med数据库、美国Ovid数据库、荷兰医学文摘数据库、万方数据库、中国知网CNKI全文数据库和中国生物医学文献数据库,按照Cochrane协作网推荐的纳入标准筛选文献并进行质量评价,采用Stata 12.0进行Meta分析。结果纳入文献6篇,AIDS合并PSM共893例,其中两性霉素B治疗467例,氟康唑治疗152例,伊曲康唑治疗274例。Meta分析结果显示:两性霉素B治疗好转率高于氟康唑[OR=7.138(95%CI 1.761~28.932),P0.05],病死率低于氟康唑[OR=0.507(95%CI 0.294~0.875),P0.05],差异均具有统计学意义;两性霉素B与伊曲康唑对比,治疗好转率[OR=0.777(95%CI 0.498~1.212),P0.05]和病死率[OR=1.427(95%CI 0.890~2.287),P0.05]差异均无统计学意。结论两性霉素B治疗AIDS合并PSM效果优于氟康唑,与伊曲康唑比较疗效无明显差异。今后应积累更多前瞻性资料进一步证实。
[Abstract]:Objective to evaluate the efficacy of amphotericin B, fluconazole and itraconazole in the treatment of AIDS with penicilliosis marneffei (penicilliosis marneffei,PSM) by Meta. Methods Cochrane Library, Pub Med Database, Ovid Database, Netherlands Medical Abstract Database, Wanfang Database, CNKI Full-text Database and Biomedical Literature Database were searched. According to the standard recommended by Cochrane, the literature was screened and the quality was evaluated. Stata 12.0 was used for Meta analysis. Results there were 893 cases of AIDS combined with PSM, including 467 cases treated with amphotericin B and 152 cases treated with fluconazole. The results of Meta analysis showed that the improvement rate of amphotericin B was higher than that of fluconazole [OR=7.138 (95%CI 1.761v 28.932), P0.05], and the mortality was lower than that of OR=0.507 (95%CI 0.294 卤0.875). P0.05, the differences were statistically significant. Compared with itraconazole, the improvement rate of amphotericin B [OR=0.777 (95%CI 0.498U 1.212), P0.05] and the mortality rate (OR=1.427 (95%CI 0.890 卤2.287), P0.05) had no statistical significance. Conclusion Amphotericin B is superior to fluconazole in the treatment of AIDS with PSM, but there is no significant difference between amphotericin B and itraconazole. More prospective data should be accumulated in the future to further confirm.
【作者单位】：广西南宁市第四人民医院
【基金】：广西壮族自治区南宁市科学研究与技术开发计划项目(20123109)
【分类号】：R512.91;R519

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