霉酚酸酯与环磷酰胺治疗重型狼疮肾炎的Meta分析  

Meta-analysis of mycophenolate mofetil versus cyclophosphamide for severe proliferative lupus nephritis

作　　者：蔡晓懿[1] 夏正坤[1] 张莹[1] 刘梦圆[1] 李静[1] 张婕[1] 

机构地区：[1]南京大学医学院临床学院南京军区南京总医院儿科,210002

出　　处：《中华临床医师杂志（电子版）》2012年第24期8160-8166,共7页Chinese Journal of Clinicians(Electronic Edition)

基　　金：江苏省重点医学人才基金资助(RC2007115);南京军区医药卫生科研基金课题资助(11MA098)

摘　　要：目的评价霉酚酸酯与环磷酰胺治疗重型狼疮性肾炎的疗效及安全性。方法电子检索PubMed、EMBASE、Cochrane图书馆临床对照试验资料库、中国期刊全文数据库(CNKI)等数据库,检索霉酚酸酯与环磷酰胺治疗重型狼疮性肾炎的随机对照临床试验,对完全缓解率、部分缓解率、总缓解率、感染、白细胞减少、胃肠道反应、闭经发生率、死亡率及复发率进行Meta分析。结果共12篇文献纳入研究(共925例),Meta分析结果显示霉酚酸酯较环磷酰胺完全缓解率及总缓解率高,同时感染、白细胞减少、闭经的发生,霉酚酸酯较环磷酰胺明显减少,两组间胃肠道反应、复发、死亡率无统计学差异。结论目前分析结果表明霉酚酸酯较传统的环磷酰胺治疗重型狼疮性肾炎疗效好,安全性高。Objective To evaluate the efficacy and safety of mycophenolate mofetil and cyclophosphamide in treatment of severe lupus nephritis.Methods The data of PubMed,EMBASE,Cochrane Library,CNKI were retrieved to search the studies about the randomized controlled clinical trials(RCTs)in the treatment of severe lupus nephritis by mycophenolate mofetil or cyclophosphamide.Meta-analysis was made to assess the complete remission,partial remission,total remission,infection,leucopenia,gastrointestinal symptoms,amenorrhea,death rate and relapse.Results Twelve RCTs in which included 925 patients were collected.Meta-analysis showed that compared with the cyclophosphamide,mycophenolate mofetil was more effective in complete remissions total remission.The incidence of infection,leucopenia and amenorrhea after mycophenolate mofetil treatment was lower than cyclophosphamide in treatment for severe lupus nephritis,while there was no significant difference in that of gastrointestinal symptoms,relapse and death rate.Conclusions The current limited evidence suggests that mycophenolate mofetil is more effective and safe than traditional protocols in treatment of severe lupus nephritis.

关 键 词：环磷酰胺 狼疮肾炎 META分析 霉酚酸酯 

分 类 号：R593.242[医药卫生—内科学]