重组人血小板生成素治疗免疫性血小板减少症的系统评价

发布时间：2017-12-28 11:09

本文关键词：重组人血小板生成素治疗免疫性血小板减少症的系统评价　出处：《南昌大学》2015年硕士论文　论文类型：学位论文

【摘要】：研究目的:系统性评价重组人血小板生成素(rhTPO)在免疫性血小板减少症(ITP)治疗中的疗效与安全性。研究方法:计算机检索PubMed、the Cochrane Libaray、CBM、CNKI、Wangfang Data,查找国内外已经发表的所有有关rhTPO治疗免疫性血小板减少症的随机对照研究(RCT),检索时限为建库至2014年11月。由2名研究者根据纳入和排除标准进行文献筛选、资料提取以及质量评价,最后采用RevMan5.2软件进行Meta分析。研究结果:最终纳入5项RCT试验,共192例(初治+难治)患者。Meta分析结果显示:rhTPO联合糖皮质激素组优于激素单药组,显效率[OR=2.1625,95%CI(1.06,4.38),P=0.03]、有效率[OR=3.25,95%CI(1.26,8.39),P=0.01];在血小板开始上升所需的时间[WMD=-4.00,95%CI(-4.66,-3.16),P0.00001]、血小板达50x109/L所需时间[WMD=-5.25,95%CI(-6.31,-4.18),P0.00001]及血小板达峰时间[WMD=-9.99,95%CI(-15.27,-4.70),P=0.00002]方面,rhTPO联合糖皮质激素组优于激素单药组;在血糖升高[OR=0.43,95%CI(0.10,1.85),P=0.26]、血压升高[OR=0.73,95%CI(0.18,2.97),P=0.66]方面,两组差异无统计学意义。结论:rhTPO联合糖皮质激素能提高ITP患者治疗的显效率及有效率,并能缩短血小板开始上升时间、血小板达50x109/L及血小板达峰所需时间;而在血糖、血压升高方面,两组差异无统计学意义。然而受纳入样本数量及质量所限,故本系统性评价结论还需更多高质量的研究进一步证实。
[Abstract]:Objective: To study the systematic evaluation of recombinant human thrombopoietin (rhTPO) in immune thrombocytopenia (ITP) efficacy and safety in the treatment of. Research methods: PubMed, the Cochrane Libaray, CBM, CNKI and Wangfang Data were searched by computer to find all the randomized controlled trials (RCT) published at home and abroad about rhTPO for the treatment of immune thrombocytopenia. The time limit for retrieval was from November 2014 to November 2014. 2 researchers were selected according to the inclusion and exclusion criteria for literature screening, data extraction and quality evaluation. Finally, the RevMan5.2 software was used for Meta analysis. Results: in the end, 5 RCT trials were included in 192 patients (initial treatment + refractory). The results of Meta analysis showed that rhTPO combined with glucocorticoid hormone group is better than the single drug group, the significant efficiency of [OR=2.1625,95%CI (1.06,4.38), P=0.03], [OR=3.25,95%CI, P=0.01] efficiency (1.26,8.39); platelet began to rise in the time required for [WMD=-4.00,95%CI (-4.66, -3.16), P0.00001], platelet reached 50x109/L the time required for [WMD=-5.25,95%CI (-6.31, -4.18) P0.00001], peak time and platelet [WMD=-9.99,95%CI (-15.27, -4.70), P=0.00002], rhTPO combined with glucocorticoid hormone group is better than the single drug group; in elevated blood glucose (0.10,1.85), [OR= 0.43,95%CI P=0.26] [OR=0.73,95%CI (0.18,2.97), elevated blood pressure, P=0.66], no significant difference between two groups. Conclusion: rhTPO combined with glucocorticoids can improve the markedly effective rate and effective rate of ITP patients, and shorten the time of platelet start up, the time of platelet reaching 50x109/L and the time to reach the peak of platelet. However, there is no significant difference in blood glucose and blood pressure between the two groups. However, it is limited by the quantity and quality of the included samples, so the systematic evaluation conclusions need more high quality research.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R558.2

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