Meta分析比较抗-D免疫球蛋白与大剂量静脉丙种球蛋白治疗儿童急性特发性血小板减少性紫癜的有效性及安全性
发布时间：2018-10-25 20:58
【摘要】：目的：比较静脉注射抗-D免疫球蛋白(anti-D immunoglobulin,anti-D)与大剂量静脉丙种球蛋白(IVIG)治疗儿童急性特发性血小板减少性紫癜(ITP)的有效性及安全性。 方法：对anti-D治疗儿童急性ITP的随机对照试验(与大剂量IVIG相比)进行系统评价和Meta分析。计算机检索Pubmed.Embase和Cochrane Central Register of Controlled Trials.手工检索计算机检索出的文献的参考文献目录。两名评价者独立完成文献筛选、文献质量评价及资料提取,并作交叉核对。选取治疗72h后血小板计数20×109/L的百分率和血红蛋白下降值作为主要测量指标。采用RevMan5.1对纳入文献进行Meta分析。各研究间无异质性时,采用固定效应模型,反之,采用随机效应模型。 结果：共检索到相关文献771篇,有5篇文献符合纳入标准。治疗72h后anti-D组与IVIG组血小板计数20×109/L比较：RR=0.90,95%CI：0.82-0.98,差异有统计学意义；亚组分析：anti-D50μg·kg-1与IVIG比较：RR=0.98,95%CI：0.84～1.13；75μ g·kg-1与IVIG比较：RR=0.88,95%CI：0.75-1.03,差异均无统计学意义。anti-D组血红蛋白下降更明显,但患者均不需要输注悬浮红细胞。 结论：静脉注射anti-D治疗儿童急性特发性血小板减少性紫癜的疗效可能与大剂量IVIG相同。患者对anti-D的副作用耐受性良好。
[Abstract]:Objective: to compare the efficacy and safety of intravenous anti-D immunoglobulin (anti-D immunoglobulin,anti-D) and high dose intravenous immunoglobulin (IVIG) in the treatment of acute idiopathic thrombocytopenic purpura (ITP) in children. Methods: the randomized controlled trial (compared with high dose IVIG) of anti-D for children with acute ITP was systematically evaluated and analyzed by Meta. Computer retrieval of Pubmed.Embase and Cochrane Central Register of Controlled Trials. Manually search the bibliography of the documents retrieved by computer. Two evaluators independently completed literature screening, literature quality evaluation and data extraction, and cross-check. The percentage of platelet count 20 脳 109 / L and the decrease of hemoglobin were selected as the main indexes after 72 hours of treatment. RevMan5.1 was used to analyze the included literature by Meta. When there is no heterogeneity among the studies, the fixed effect model is used, whereas the random effect model is adopted. Results: a total of 771 articles were retrieved, 5 of which met the inclusion criteria. Platelet count 20 脳 10 9 / L in anti-D group and IVIG group 72 h after treatment: RR=0.90,95%CI:0.82-0.98, difference was statistically significant; subgroup analysis: anti-D50 渭 g kg-1 versus IVIG: RR=0.98,95%CI:0.84~1.13; Compared with IVIG, 75 渭 g kg-1 showed no significant difference in RR=0.88,95%CI:0.75-1.03,. Hemoglobin decreased significantly in anti-D group, but the patients did not need to be infused with suspended red blood cells. Conclusion: the effect of intravenous injection of anti-D on children with acute idiopathic thrombocytopenic purpura may be the same as that of high dose IVIG. Patients with anti-D have good tolerance for side effects.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.5
本文编号：2294824
[Abstract]:Objective: to compare the efficacy and safety of intravenous anti-D immunoglobulin (anti-D immunoglobulin,anti-D) and high dose intravenous immunoglobulin (IVIG) in the treatment of acute idiopathic thrombocytopenic purpura (ITP) in children. Methods: the randomized controlled trial (compared with high dose IVIG) of anti-D for children with acute ITP was systematically evaluated and analyzed by Meta. Computer retrieval of Pubmed.Embase and Cochrane Central Register of Controlled Trials. Manually search the bibliography of the documents retrieved by computer. Two evaluators independently completed literature screening, literature quality evaluation and data extraction, and cross-check. The percentage of platelet count 20 脳 109 / L and the decrease of hemoglobin were selected as the main indexes after 72 hours of treatment. RevMan5.1 was used to analyze the included literature by Meta. When there is no heterogeneity among the studies, the fixed effect model is used, whereas the random effect model is adopted. Results: a total of 771 articles were retrieved, 5 of which met the inclusion criteria. Platelet count 20 脳 10 9 / L in anti-D group and IVIG group 72 h after treatment: RR=0.90,95%CI:0.82-0.98, difference was statistically significant; subgroup analysis: anti-D50 渭 g kg-1 versus IVIG: RR=0.98,95%CI:0.84~1.13; Compared with IVIG, 75 渭 g kg-1 showed no significant difference in RR=0.88,95%CI:0.75-1.03,. Hemoglobin decreased significantly in anti-D group, but the patients did not need to be infused with suspended red blood cells. Conclusion: the effect of intravenous injection of anti-D on children with acute idiopathic thrombocytopenic purpura may be the same as that of high dose IVIG. Patients with anti-D have good tolerance for side effects.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.5
【共引文献】
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1 泥永安;刘壮;;抗-D免疫球蛋白治疗儿童特发性血小板减少性紫癜研究进展[J];实用儿科临床杂志;2012年03期
，本文编号：2294824
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