促红细胞生成素治疗恶性肿瘤贫血的Meta分析  

Erythropoietin for Cancer-Related Malignant Anemia:A Meta-analysis

作　　者：姚小健[1] 刘春霞[1] 

机构地区：[1]兰州大学第一医院,兰州730000

出　　处：《中国循证医学杂志》2010年第7期842-847,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价促红细胞生成素对非放疗、化疗所致恶性肿瘤贫血的疗效。方法计算机检索PubMed(1966～2009.9)、EMbase(1974～2009.9)、CochraneLibrary(Issue3,2009)、CBM(1978～2009.9)、CNKI(1994～2009.9)和VIP(1989～2009.9)等数据库,并辅以手工检索,收集促红细胞生成素治疗恶性肿瘤贫血的随机对照试验,按照纳入标准由两名研究者独立筛选试验并提取资料,采用Cochrane Handbook 5.0推荐的文献质量评价标准评价纳入研究,采用RevMan 5.0软件进行统计学处理。结果共纳入12个比较促红细胞生成素与空白对照治疗恶性肿瘤贫血的随机对照试验,其中10个研究质量评价等级为B、2个为C,纳入研究的方法学质量较低。Meta分析结果显示:与空白对照相比,促红细胞生成素可以减少输血量[SMD= -0.66,95%CI(-1.14,-0.17),P=0.008]、需要输血的人数[OR=0.60,95%CI(0.39,0.92),P=0.02]和治疗2周后血红蛋白变化值[SMD=2.40,95%CI(0.29,4.52),P=0.03],其差异均有统计学意义。结论当前证据表明:促红细胞生成素对非放疗、化疗所致癌性贫血有效。限于对各指标可合并的研究有限,还需要大样本、高质量的随机对照试验来进一步评价。Objective To assess the effectiveness and safety of erythropoietin（EPO） for cancer-related malignant anemia without radiotherapy or chemotherapy.Methods Randomized controlled trials（RCTs） or quasi-randomized controlled trials（quasi-RCTs） involving erythropoietin in the treatment of cancer-related malignant anemia were searched and identified from PubMed（1966 to Sept.2009）,EMBASE（1974 to Sept.2009）,The Cochrane Library（Issue 3,2009）,CBM（1978 to Sept.2009）,CNKI（1994 to Sept.2009）,VIP（1989 to Sept.2009）.We also handsearched relevant journals.Data were extracted and evaluated by two reviewers independently with specially designed extraction form.We evaluated the quality of the included studies by the Cochrane Handbook 5.0 recommend standard and analyzed data by Cochrane Collaboration＇s RevMan 5.0.Results We included twelve trials.The quality of the included studies was poor.The grade of ten studies was B,and the grade of two studies was C.Meta-analyses showed that there were significant differences between erythropoietin and blank in volume of blood transfusion [SMD=-0.66,95%CI（-1.14,-0.17）,P=0.008],number need to transfusion [OR=0.60,95%CI（0.39,0.92）,P=0.02],and the change of hemoglobin a er two-week therapy [SMD=2.40,95%CI（0.29,4.52）,P=0.03].Conclusion The current evidence shows that EPO significantly bene ts cancer-related malignant anemia.Well-designed RCTs with a larger sample size,longer intervention and follow-up periods are still needed.

关 键 词：促红细胞生成素 恶性肿瘤贫血 随机对照试验 META分析 

分 类 号：R730.5[医药卫生—肿瘤]