美罗培南改良输注方式对比传统输注方式治疗严重感染疗效和安全性的Meta分析  

Efficacy and Safety of Modified Infusion versus Traditional Infusion of Meropenem in the Treatment of Severe Infectious:a Meta-analysis

作　　者：肖宇博[1] 李荣凌[1] 吴丽丽[2] 沈秉正[1] 张璐[1] 

机构地区：[1]武汉大学人民医院药学部,武汉430060 [2]武汉大学人民医院新生儿科,武汉430060

出　　处：《中国药房》2015年第24期3378-3382,共5页China Pharmacy

摘　　要：目的：系统评价美罗培南改良输注方式（2~4 h输注或持续24 h输注）对比传统输注方式（0.5~1 h输注）治疗严重感染的疗效和安全性,以为临床治疗提供循证参考。方法：计算机检索Medline、中国期刊全文数据库、中文科技期刊数据库、万方数据库,检索美罗培南改良输注方式（试验组）对比传统输注方式（对照组）治疗严重感染的系列研究,提取资料并评价质量后,采用Rev Man 5.0统计软件进行Meta分析。结果：共纳入13项临床研究,合计1 012例患者。Meta分析结果显示,试验组患者临床有效率[RR=1.25,95%CI（1.10,1.43）,P〈0.001]和细菌清除率[RR=1.25,95%CI（1.05,1.48）,P=0.01]显著高于对照组,而死亡率[RR=0.74,95%CI（0.46,1.18）,P=0.21]和不良反应发生率[RR=0.81,95%CI（0.48,1.39）,P=0.45]与对照组比较,差异无统计学意义。结论：与传统输注方式相比,延长或持续输注美罗培南可提高治疗严重感染的疗效,两者安全性相当。受纳入研究方法学质量的限制,该结论有待大样本、高质量的随机对照试验进一步验证。OBJECTIVE： To systematically evaluate the efficacy and safety of modified infusion（2-4 h infusion or continuous 24 h infusion） versus traditional infusion （0.5-1 h infusion） of meropenem in the treatment of severe infectious, and to provide evidence-based reference for clinic treatment. METHODS： Retrieved from Medline, CJFD, VIP database and Wanfang database, modified infusion （test group） versus traditional infusion （control group） of meropenem in the treatment of severe infections were collected, and Mata-analysis was performed by using Rev Man 5.0 statistical software after extracting data and evaluating quality. RESULTS： A total of 13 studies were included, involving 1 012 patients. Results of Meta-analysis showed the effective rate [RR= 1.25,95%CI（1.10,1.43） ,P〈0.001] and bacterial eradication rate [RR=1.25,95%CI（1.05,1.48） ,P=0.01] in test groups were significantly higher than those of control group, and there were no significant differences in the mortality rate [RR=0.74, 95% CI （0.46, 1.18）,P=0.21] and incidence of adverse reactions [RR=0.81,95%CI（0.48, 1.39）,P=0.45]. CONCLUSIONS： Compared with traditional infusion of meropenem, extended or continUous infusion can improve efficacy in the treatment of severe infections, with similar safety. Due to methodology limit of included studies, large-scale and high quality RCT are required for further validation of the conclusions.

关 键 词：美罗培南 改良输注方式 META分析 疗效 安全性 

分 类 号：R978.1[医药卫生—药品]