更昔洛韦治疗婴儿巨细胞病毒肝炎的系统评价  

Systematic review of benefits and harms of ganciclovir for infantile cytomegalovirus hepatitis

作　　者：顾绍庆[1] 郑意[2] 陈慧娟[3] 李继安[2] 叶亮英[2] 

机构地区：[1]江苏大学附属人民医院儿科,江苏镇江212002 [2]江苏大学临床医学院,江苏镇江212013 [3]江苏大学附属医院内科,江苏镇江212001

出　　处：《江苏大学学报（医学版）》2010年第6期500-506,共7页Journal of Jiangsu University：Medicine Edition

基　　金：江苏省自然科学基金资助项目(BK2008238)

摘　　要：目的:评价更昔洛韦(ganciclovir,GCV)治疗婴儿巨细胞病毒肝炎的疗效。方法:制定原始文献的纳入标准、排除标准及检索策略,检索Medline、CNKI期刊全文数据库、万方数字化期刊及重庆维普信息数据库,同时辅以手工检索会议资料和学位论文。收集GCV治疗婴儿巨细胞病毒性肝炎的随机对照临床研究,对符合入选标准的研究用RevMan 5.0软件进行Meta分析。结果:共纳入14项研究,包括624例患者。Meta分析结果表明,与对照组相比,GCV治疗组能够降低血清总胆红素(TBIL)、丙氨酸转氨酶(ALT),缩短TBIL、ALT复常时间;巨细胞病毒抗体(CMV-IgM)及巨细胞病毒脱氧核糖核酸(CMV-DNA)转阴率优于对照组;GCV治疗组较对照组的不良反应发生率增高,主要表现为白细胞和血小板下降、胃肠道反应、皮疹和肝功能异常,一般未造成严重后果。结论:对婴儿巨细胞病毒肝炎,GCV在改善肝功能,感染指标转阴方面优于对照组,安全性可能较高。Objective： To assess the effect of ganciclovir（GCV） for cytomegalovirus hepatitis in infants.Methods： The following electronic databases of Medline,CNKI,WANFANG and VIP were searched to identify the randomized controlled trials of GCV for cytomegalovirus hepatitis in infants.For inclusion of GCV-based RCT in the therapy of cytomegalovirus hepatitis as many as possible,relevant papers were manually obtained from a collection of meeting proceedings and thesis.The search strategy was made according to the Collaborative Review Group search strategy.The quality of literature was evaluated and Meta-analysis was conducted using RevMan 5.0 software.Results： Fourteen studies with 624 participants were included.Compared with the control group,Meta-analysis showed that the treatment group evidently decreased TBIL and ALT.The time recovery of TBIL and ALT was significantly shorter than treatment group.The negative rate of CMV-IgM and CMV-DNA of treatment group were superior to that of control group.The GCV increased the incidence of GCV-therapy-related side effects as compared with control group.Leukopenia,thrombocytopenia,the functional disturbances of gastrointestinal tract,rash and hepatic dysfunction were recovered after treatment.Conclusion： GCV is an effective medicine used in the treatment of infantile CMV hepatitis.The incidence of the GCV-therapy-related side effects was low.

关 键 词：更昔洛韦 巨细胞病毒 肝炎 系统评价 META分析 

分 类 号：R72[医药卫生—儿科] R19[医药卫生—临床医学]