环磷酰胺不同给药方式治疗抗中性粒细胞胞浆抗体相关性血管炎的Meta分析  

Meta-analysis of different administration routes of cyclophosphamide in treatment of ANCA associated vacuities

作　　者：何梅[1,2] 赵曜[1] 周玥[1] 杨明[1] 刘福[1] 

机构地区：[1]川北医学院附属医院药剂科,四川南充637000 [2]川北医学院药学院,四川南充637000

出　　处：《实用医院临床杂志》2016年第3期24-28,共5页Practical Journal of Clinical Medicine

基　　金："十二五"国家科技支撑计划课题(编号:2013BAI06B04)

摘　　要：目的评价环磷酰胺不同给药方式治疗抗中性粒细胞胞浆抗体相关性血管炎的有效性和安全性。方法计算机检索Pub Med、Medline、Embase、Cochrane图书馆、CBM、VIP、CNKI数据库,评价纳入实验的方法学质量,并提取资料,采用Rev Man5.2软件对数据进行Meta分析。结果共纳入7篇随机对照实验。Meta分析显示,静脉冲击用环磷酰胺较口服环磷酰胺复发率高（RR 0.73,95%CI 1.24~2.42）、白细胞减少率低（RR 0.51,95%CI 0.36~0.73）,诱导缓解失败率、感染、终末期肾衰竭差异无统计学意义。结论静脉冲击用环磷酰胺治疗ANCA相关性血管炎与连续口服相比诱导缓解效果相似,白细胞减少的发生率较低,但复发率较高。Objective To evaluate the efficacy and safety of different administration routes of cyclophosphamide in the treatment of ANCA associated vacuities. Methods Data were searched in Pub Med,Medline,Embase,Cochrane Library,CBM,VIP and CNKI databases.The methodology of selected trials was evaluated and relevant data were extracted. Meta- analysis was conducted with Rev Man 5. 0 software.Results The meta-analysis of 7 included RCTs showed that pulse intravenous administration of cyclophosphamide had higher relapse rate（ RR = 0. 73; 95%CI = 1. 24 ~ 2. 42） and lower reduction rate of white blood cells（ RR = 0. 51; 95%CI = 0. 36 ~ 0. 73） than daily oral cyclophosphamide did.Equivalent rate of remission infection and end-state renal failure were not significant between the two methods.Conclusion Compared to the daily oral cyclophosphamide,the intravenous pulse method has similar effect in equivalent remission rate and lower reduction rate of white blood cells.However,the intravenous method has higher relapse rate than the oral method.

关 键 词：环磷酰胺 给药途径 ANCA相关性血管炎 META分析 

分 类 号：R593.27[医药卫生—内科学] R453[医药卫生—临床医学]