扁桃体切除术联合药物治疗IgA肾病的Meta分析  

Tonsillectomy Combined with Drugs for IgA Nephropathy: A Meta Analysis

作　　者：沈琪[1] 杨彤[1] 欧阳小琳[1] 黄献文[1] 黄贤贵[1] 

机构地区：[1]广西柳州市人民医院儿科,545006

出　　处：《中国全科医学》2014年第26期3105-3108,共4页Chinese General Practice

基　　金：广西壮族自治区卫生厅自筹经费科研课题(Z2012567)

摘　　要：目的采用Meta分析方法评价扁桃体切除术联合药物治疗IgA肾病的疗效。方法计算机检索中国生物医学文献数据库、中国知网、维普网、Cochrane图书馆、PubMed和EMBase数据库,检索时间均从建库至2013-06-30。对纳入的文献进行质量评价和资料提取,采用RevMan 5.0软件进行分析。结果共纳入8篇前瞻性对照研究,包含834例患者,所有文献的质量均评为C级。Meta分析结果显示:扁桃体切除术联合激素与单用激素比较,尿蛋白缓解率、尿红细胞缓解率和完全缓解率增加(P<0.05);扁桃体切除术联合免疫抑制剂与单用免疫抑制剂比较,尿红细胞缓解率增加(P<0.05);扁桃体切除术与单用激素比较,患者完全缓解率增加(P<0.05)。结论与单用激素比较,单用扁桃体切除术或联合激素均能提高IgA肾病的完全缓解率,且以联合治疗效果最明显;扁桃体切除术联合免疫抑制剂与单用免疫抑制剂的疗效比较尚不能得出明确结论。Objective To evaluate the effects of Tonsillectomy combined with drug treatment on immunoglobulin A nephropathy（ IgAN）. Methods The CBMDisc,CNKI,VIP,Cochrane library,PubMed and EMBase for prospective studies were retrieved from the start of the databases till June 30 2013. A quality analysis was performed on the enrolled literatures and data extracted. RevMan 5. 0 software was used. Results This study enrolled a total of 8 prospective control studies,including834 patients. The qualities of all literatures were named C- class. By Meta analysis,the remission rates and complete remission rates of urine protein,erythrocyte of tonsillectomy with hormone were higher than those of single- use of hormone（ P 〈 0. 05）.The remission rate of erythrocyte of tonsillectomy with immunodepressant was higher than that of single- use of immunodepressant（ P 〈0. 05）. The complete remission rate of tonsillectomy was higher than that of single-use of hormone（ P 〈0.05）. Conclusion Tonsillectomy with hormone can improve the complete remission of IgAN and the combination treatment is the most effective. Whether tonsillectomy with immunodepressant is better than single- use of immunodepressant is not yet too a clear conclusion.

关 键 词：扁桃体切除术 肾小球肾炎 IgA 糖皮质激素类 免疫抑制剂 META分析 

分 类 号：R692.9[医药卫生—泌尿科学]