卡泊芬净预防和治疗恶性血液病患者侵袭性真菌感染的Meta分析

发布时间：2018-05-01 17:02

本文选题：卡泊芬净 + 恶性血液病　；参考：《中国临床药理学杂志》2017年05期

【摘要】：目的系统评价卡泊芬净预防和治疗恶性血液病患者合并侵袭性真菌感染的有效性与安全性。方法计算机检索中国知网(CNKI)、中国生物医学文献光盘数据库(CBM)、万方、Pubmed、Em Base、Cochrane Library数据库,纳入卡泊芬净预防和治疗血液病患者合并侵袭性真菌感染的相关随机对照试验,检索时限为建库至2016年6月。由2位研究者独立对纳入的文献进行筛选、提取资料,用Revman 5.0软件进行分析。结果共纳入随机对照试验研究10项,共769例患者,其中试验组356例,对照组413例。Meta分析显示,组间异质性检验结果良好,可用固定效应模型分析。卡泊芬净预防和治疗恶性血液病患者合并侵袭性真菌感染的有效率与两性霉素B、伊曲康唑、伏立康唑相比,差异无统计学意义(P0.05)。但是有6项研究表明,卡泊芬净的药物不良反应发生率比两性霉素B低(P0.01),有2项研究表明卡泊芬净的药物不良反应发生率比伊曲康唑低(P0.01),差异均有统计学意义。有1项研究表明卡泊芬净与伏立康唑相比,药物不良反应发生率低,但差异无统计学意义(P0.05)。结论卡泊芬净在预防和治疗恶性血液病患者合并侵袭性真菌感染过程中虽然疗效未见明显优势,但药物不良反应发生率显著低于对照药,表现出安全低毒的特点。
[Abstract]:Objective to evaluate the efficacy and safety of carpofen in the prevention and treatment of invasive fungal infection in patients with malignant hematological diseases. Methods A computerized search was conducted for CNKI, China Biomedical document Disc Database (CBM), and Library database for Pubmedmedus emBasesii Cochrane, which were included in the randomized controlled trial of the prevention and treatment of carpofen in patients with hematologic diseases complicated with invasive fungal infection. The time limit for retrieval is to build the database until June 2016. The literature was screened by two researchers, and the data were extracted and analyzed by Revman 5.0 software. Results A total of 769 patients were included in 10 randomized controlled trials, including 356 patients in the trial group and 413 patients in the control group. Meta-analysis showed that the results of heterogeneity test between groups were good and could be analyzed by fixed effect model. Compared with amphotericin B, itraconazole and voleconazole, the effective rate of prevention and treatment of invasive fungal infection in patients with malignant hematological diseases was not significantly different from that of amphotericin B, itraconazole and voleconazole (P 0.05). However, six studies showed that the incidence of adverse drug reactions of carpofen was lower than that of amphotericin B. two studies showed that the incidence of adverse drug reactions of carpofen was lower than that of itraconazole, and the difference was statistically significant. One study showed that the incidence of adverse drug reactions was lower than that of fulconazole, but the difference was not statistically significant (P 0.05). Conclusion Carpofen can prevent and treat malignant hematological diseases with invasive fungal infection, but the incidence of adverse drug reactions is significantly lower than that of control drugs, showing the characteristics of safety and low toxicity.
【作者单位】：解放军总医院药学部临床药学中心;
【基金】：国家自然科学基金资助项目(81501730)
【分类号】：R733;R519

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