英夫利昔单抗治疗重症酒精性肝炎的系统评价  

The system assessment of infliximab in treatment of severe alcoholic hepatitis

作　　者：田晓娟[1] 郭元虎[1] 李慧妍[1] 

机构地区：[1]包头医学院第一附属医院消化科,014010

出　　处：《中国医师进修杂志》2014年第12期37-39,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 评价英夫利昔单抗治疗重症酒精性肝炎（SAH）的临床疗效和安全性.方法 计算机检索PubMed、EMbase、Web of Science、OVID和Cochrane图书馆系统评价资料库、CBMdisc和中国期刊网全文数据库（CNKI）等电子数据库,检索时限为建库至2013年3月,以SAH、重症酒精性肝病、英夫利昔单抗、肿瘤坏死因子拮抗剂等名称作为关键词、主题词、自由词,查找英夫利昔单抗治疗SAH的随机对照试验（RCT）,对符合纳入标准的临床研究进行Meta分析.结果 共纳入2篇RCT,56例SAH患者,采用英夫利昔单抗（10 mg/kg）联合糖皮质激素（40 mg/d）治疗SAH,可能因严重感染的高患病率而加速患者死亡,预后不良;采用英夫利昔单抗（5 mg/kg）联合糖皮质激素（40mg/d）治疗,具有良好的耐受性,患者的Maddrey评分显著改善.结论 现有的临床证据显示,英夫利昔单抗治疗SAH的疗效和安全性依据不足,需要更多大样本、不同剂量的RCT指导临床.Objective To systematic review the clinical efficacy and safety of infliximab in treatment of severe alcoholic hepatitis （SAH）. Methods The electronic database of PubMed, EMbase, Web of Science, OVID and Cochrane systematic review database, CBM disc and CNKI from building the database until March 2013 were retrieved. With ＂SAH＂, ＂severe alcoholic hepatitis＂, ＂infliximab＂ and ＂tumor necrosis factor＂ as key words or free words. Randomized-controlled trials （RCT） on infliximab in treatment of SAH was selected and analyzed by Meta analysis. Results Two RCTs was enrolled,included 56 SAH patients. Infliximab （10 mg/kg） combined with glucocorticoids （40 mg/d） might accelerate death because of the high prevalence of serious infections. Infliximab （5 mg/kg） combined glucocorticoids （40 mg/d） had more tolerability and improved patient＇s Maddrey scores significantly. Conclusions Existing clinical evidence suggest that it is short of evidence for the clinical efficacy and safety of infliximab. It need guide by large sample of clinically and different doses RCT.

关 键 词：肝炎 酒精性 英夫利昔单抗 药物评价 

分 类 号：R575.1[医药卫生—消化系统]