抗炎保肝药对结核合并乙型肝炎病毒表面抗原阳性患者肝损害预防作用的系统评价  

Evaluation of Efficacy of Liver Protecting Drug in Tuberculosis Patient with Positive HbsAg

作　　者：张海英[1] 任晓蕾[1] 冯婉玉[1] 

机构地区：[1]北京大学人民医院药剂科,北京100044

出　　处：《中国医院用药评价与分析》2013年第1期12-15,共4页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:系统评价抗炎保肝药对结核合并乙型肝炎病毒表面抗原阳性患者肝损害的预防作用。方法:计算机检索CBMdisc,CNKI及维普资讯-中文科技期刊数据库,纳入比较结核合并乙型肝炎病毒表面抗原阳性预防性保肝治疗的随机、对照试验(RCT);对纳入的RCT的方法学质量进行评价,并应用RevMan 5.1软件进行统计分析。结果:共10个RCT纳入研究。Meta分析结果表明,加用预防性保肝治疗组发生转氨酶异常、胆红素异常等肝损害的病例数少于常规抗结核组,差异具有统计学意义;未报道抗炎保肝药临床应用相关的严重不良反应。结论:现有临床证据表明,结核合并乙型肝炎病毒表面抗原阳性患者加用预防性保肝治疗可减少肝损害的发生,且未见明显不良反应。但由于纳入研究的文献质量所限,降低了该系统评价结论的可靠性,尚需开展更多设计合理、执行严格、多中心大样本的RCT以进一步证实。OBJECTIVE：To systematically evaluate the efficacy of liver protecting drug in tuberculosis patient with positive HbsAg.METHODS：We searched CBMdisc,CNKI and Vip.The quality of included studies such as randomization,blinding and allocation concealment was evaluated and Meta analysis was performed by RevMan 5.1 software.RESULTS：Ten randomized controlled trials（RCTs） were included.As protect liver therapy group was compared with regular anti-tuberculosis therapy group,the Meta analysis indicated that the number of liver damage（including the number of abnormal transaminase and abnormal bilirubin） of protect liver therapy group was less than regular anti-tuberculosis therapy group and showed significant difference.Serious adverse drug reactions had not been reported in the trials.CONCLUSION：According to the Meta analysis＇s result,protect liver therapy can decrease the occurrence of liver function damage,without any significant adverse drug reactions.However,the evidence was not strong due to the general low methodological quality of RCTs.Further high quality and large sample randomized controlled trials should be carried out.

关 键 词：抗炎保肝药 结核 乙型肝炎病毒表面抗原阳性 肝损害 Meta分析 

分 类 号：R975.5[医药卫生—药品]