莫西沙星与左氧氟沙星治疗耐多药结核病有效性及安全性Meta分析  

Efficacy and safety of moxifloxacin and levofloxacin in the treatment of multidrug resistance tuberculosis:a meta-analysis

作　　者：沈昊 谢利军 

机构地区：[1]南京医科大学第一附属医院国家药物临床试验机构,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2014年第12期1800-1807,共8页Journal of Nanjing Medical University(Natural Sciences)

基　　金：科技部科技重大专项"重大新药创制"(2011ZX09302-003-02);江苏省科技重大专项(BM2011017)

摘　　要：目的：评价国内莫西沙星与左氧氟沙星治疗耐多药结核病的疗效及安全性。方法：计算机检索中国生物医学文献数据库、中国期刊全文数据库、万方数据库及维普中文科技期刊全文数据库，收集2000年1月-2014年6月莫西沙星与左氧氟沙星治疗耐多药结核病的随机对照试验（RCT）文献．对纳入研究进行方法学质量评价，并采用RevMan5．3．0软件进行Meta分析。结果：共纳入36个RCT。Meta分析结果显示，莫西沙星组与左氧氟沙星组相比，莫西沙星可提高服药后3个月痰菌转阴率（OR=2．25，95％CI：1．87-2．70）、疗程结束时痰菌转阴率（OR=3．70，95％CI：2．97-4．62）、病灶吸收率（OR=2．45，95％CI：1．90—3．17）、空洞闭合率（OR=I．82，95％CI：1．45-2．29）以及临床总有效率（OR=5．08，95％CI：3．58-7．22）。两组不良反应发生率差异无统计学意义（P=0．14）。结论：目前国内证据表明，莫西沙星可有效治疗耐多药结核病，其疗效优于左氧氟沙星，不良反应发生率与其相当。Objective：To evaluate the efficacy and safety of moxifloxacin as well as levofloxacin in the treatment of multidrug resistance tuberculosis （MDR-TB） in China. Methods：Databases included the CB1Mdise,CNKI,wangfang data,and VIP from Jan, 2000 to Jun,2014 were retrospectively searched to collect randomized controlled trials （RCTs） of moxifloxacin and levofloxacin for MDR-TB. The methodological quality of included studies was evaluated,and data analyses were performed with The Cochrane Collaboration＇s software RevMan 5.3.0. Results：A total of 36 RCTs were included. The results showed that,compared with the levofloxacin group,moxifloxacin increased the sputum negative conversion rate after 3-month taking（OR=2.25,95%CI： 1.87-2.40）and at the end of the treatment period （OR=3.70,95%CI：2.97-4.62）. Moxifloxac-d was more effective in focus absorption （OR=2.45,95%CI：1.90- 3.17）,cavity closure （OR=l.82,95%CI：1.45-2.29）and clinical curative effect （OR=5.08,95%CI：3.58-7.22）. However,there was no statistical difference in incidence of adverse reaction（P=0.14）. Conclusion：According to the domestic evidence,moxifloxacin is more effective for MDR-TB than levofloxacin. Its adverse reaction rate is equivalent to levofloxacin.

关 键 词：莫西沙星 左氧氟沙星 耐多药结核 META分析 

分 类 号：R52[医药卫生—内科学]