替加环素联合治疗鲍曼不动杆菌感染疗效的Meta分析

发布时间：2018-12-24 12:58

【摘要】：目的系统评价替加环素联合治疗鲍曼不动杆菌感染的疗效与安全性。方法计算机检索Cochrane图书馆、EmBase、PubMed、Web of Science、相关期刊论文(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(VIP)和万方数据库(检索时间均从建库至2016年7月)关于替加环素联合治疗鲍曼不动杆菌的随机对照试验、队列研究。由2名研究者按入选与排除标准独立筛选试验,并对纳入研究的方法学质量进行评价,提取资料;用RevMan5.14软件对数据进行Meta分析。结果共纳入12篇随机对照研究,5篇高质量的队列研究,共涉及1908例病例,其中试验组(替加环素联合治疗组)992例,对照组(其他抗鲍曼不动杆菌药物治疗组)916例。Meta分析结果显示:试验组临床有效率优于对照组,差异有统计学意义(P0.05);试验组与对照组在微生物清除率、30 d死亡率方面差异均无统计学意义(P0.05)。结论基于现有临床证据,替加环素联合治疗鲍曼不动杆菌感染,临床有效,但对于微生物清除及30 d死亡率的影响并不优于其他常规的药物治疗组。由于纳入研究数量较少,研究质量不统一,本结论还需要更多大样本、高质量临床随机对照试验予以验证。
[Abstract]:Objective to evaluate the efficacy and safety of tegicycline in the treatment of Acinetobacter baumannii infection. Methods Cochrane Library, EmBase,PubMed,Web of Science, full text Database of Chinese Journals, (CNKI), Chinese Biomedical Literature Database, (CBM), Chinese Journal of Science and Technology Full-text Database (VIP) and Wanfang Database (search time from establishment to July 2016) A randomized controlled trial of tegacycline combined treatment of Acinetobacter baumannii cohort study. According to the criteria of inclusion and exclusion, two researchers conducted independent screening tests, evaluated the quality of methodology included in the study, extracted the data, and used RevMan5.14 software to analyze the data by Meta. Results A total of 12 randomized controlled trials and 5 high-quality cohort studies involving 1908 cases were included, including 992 cases in the trial group (tegacycline combined therapy group). Control group (other anti-Acinetobacter baumannii drug treatment group) 916 cases. The results of Meta analysis showed that the clinical effective rate of the experimental group was better than that of the control group, the difference was statistically significant (P0.05); There was no significant difference in microbial clearance rate and 30 day mortality between the experimental group and the control group (P0.05). Conclusion based on the available clinical evidence, tigicycline combined treatment of Acinetobacter baumannii infection is effective, but the effect on microbial clearance and 30-day mortality is not superior to that of other routine drug therapy groups. Due to the small number of studies included and the inconsistent quality of the study, this conclusion needs to be verified by more large samples and high quality randomized controlled trials.
【作者单位】：第三军医大学西南医院药剂科;
【基金】：国家自然科学基金资助项目(81102481)
【分类号】：R516

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