阿瑞匹坦联合5-HT_3受体拮抗剂和地塞米松预防化疗相关性恶心和呕吐的Meta分析  

Efficacy of aprepitant plus 5-HT_3 receptor antagonist and dexamethasone in the prevention of chemotherapy-induced nausea and vomiting: A Meta analysis

作　　者：黄鲁众[1] 张晓晔[1] 刘艳[1] 徐兆国[1] 崔国元[1] 

机构地区：[1]中国医科大学附属盛京医院第四肿瘤科,辽宁沈阳110020

出　　处：《现代肿瘤医学》2015年第15期2198-2203,共6页Journal of Modern Oncology

摘　　要：目的:采用Meta分析方法对阿瑞匹坦联合5-HT3受体拮抗剂和地塞米松预防化疗相关性恶心和呕吐进行系统评价。方法:检索Pubmed、EMbase、Cochrane Library、中国知网CNKI全文数据库、维普数据库、万方数据库和中国生物医学文献数据库,查找2003年1月至2013年12月公开发表的研究阿瑞匹坦联合5-HT3受体拮抗剂和地塞米松预防化疗相关性恶心和呕吐的临床随机对照试验。按照纳入与排除标准选择文献,质量评估,资料提取,采用Rev Man 5.2软件进行Meta分析。结果:共纳入12篇英文RCT文献,均为高质量研究。Meta分析结果显示,阿瑞匹坦联合5-HT3受体拮抗剂、地塞米松治疗(三联治疗)在预防高、中度致吐性化疗相关性恶心和呕吐的总体完全缓解率[OR=1.91,95%CI(1.68,2.17),P<0.00001]、急性完全缓解率[OR=1.89,95%CI(1.48,2.42),P<0.00001]、迟发性完全缓解率[OR=2.05,95%CI(1.68,2.51),P<0.00001]明显高于5-HT3受体拮抗剂、地塞米松治疗(二联治疗),两组差异有统计学意义。结论:阿瑞匹坦可以显著提高高、中度致吐性化疗的总体、急性和迟发性恶心和呕吐完全缓解率,尤其是在提高迟发性恶心和呕吐完全缓解率更为明显。Objective： To evaluate the efficacy of aprepitant plus 5-HT3 receptor antagonist and dexamethasone for the prevention of chemotherapy-induced nausea and vomiting. Methods： Studies were identified by searching Pubmed,EMbase,Cochrane Library,CNKI,VIP,Wanfang and CBM from January 2003 to December 2013. Randomized clinical trials of aprepitant plus 5-HT3 receptor antagonist and dexamethasone for the prevention of chemotherapy-induced nausea and vomiting were included. Choose studies according to the inclusion criteria and exclusion criteria,and evaluate quality retrieve data. Meta-analysis was performed for the results of studies by using Rev Man 5. 2software. Results： 12 studies were included,they were all high quality studies. The results showed that the complete response of highly and moderately emetogenic chemotherapy-induced nausea and vomiting in the overall phase[OR= 1. 91,95% CI（ 1. 68,2. 17）,P〈 0. 00001],the acute phase[OR = 1. 89,95% CI（ 1. 48,2. 42）,P〈 0. 00001],the delayed phase[OR = 2. 05,95% CI（ 1. 68,2. 51）,P〈 0. 00001] of aprepitant plus 5-HT3 receptor antagonist,and dexamethasone treatment（ triple therapy） was significantly higher than that of 5-HT3 receptor antagonist and dexamethasone treatment（ bigeminal therapy）,and there was statistically significant difference between the two groups.Conclusion： Aprepitant can significantly increase the complete response of highly and moderately emetogenic chemotherapy-induced nausea and vomiting in the overall,acute and delayed phase,and especially in the delayed phase,the result was more obvious.

关 键 词：阿瑞匹坦 5-HT3受体拮抗剂 化疗相关性恶心和呕吐 完全缓解率 META分析 

分 类 号：R73-36[医药卫生—肿瘤]