扁桃体切除术联合药物治疗IgA肾病Meta分析  

Tonsillectomy combined with medication therapy in patients with immunoglobulin A nephropathy:a meta-analysis

作　　者：马续祥 辛玲[2] 李莹[1] 纵晓英[1] 钱平[1] 

机构地区：[1]蚌埠医学院第二附属医院肾内科,安徽蚌埠233040 [2]蚌埠医学院第二附属医院神经外科,安徽蚌埠233040

出　　处：《临床荟萃》2016年第8期905-908,共4页Clinical Focus

摘　　要：目的评价扁桃体切除术联合药物（tonsillectomy combined with medication therapy,TCMT）治疗IgA肾病的疗效。方法检索Embase、PubMed、中国生物医学文献数据库（CBM）、中国期刊网（CNKI）等数据库公开发表的关于TCMT治疗IgAN的研究文献,末次检索时间为2016年3月31日。纳入以扁桃体切除术联合药物治疗为干预措施治疗IgA肾病的随机对照试验和前瞻性对照试验,并对纳入文献质量进行评价,采用Stata 13.0软件进行meta分析。结果共纳入6篇文献,3篇为前瞻性对照研究,3篇为随机对照研究。（1）总体疗效：符合标准的文献3篇,总样本量224例,其中TCMT组134例,药物治疗组90例,meta分析示两组疗效差异有统计学意义（OR=2.68,95%CI=1.47-4.90,P=0.001）。（2）尿蛋白缓解率：符合标准的文献5篇,总样本量326例,其中TCMT组167例,药物治疗组159例,meta分析示两组疗效差异有统计学意义（OR=4.38,95%CI=2.67-7.20,P〈0.001）。（3）尿红细胞缓解率：符合标准的文献5篇,总样本量326例,其中TCMT组167例,药物治疗组159例,meta分析示两组疗效差异有统计学意义（OR=3.90,95%CI=1.38-11.07,P=0.01）。结论从现有的临床证据看,扁桃体切除术联合药物治疗可显著提高总体疗效、尿蛋白缓解率及尿红细胞缓解率,疗效优于单用药物治疗。Objective To evaluate the efficacy of tonsillectomy combined with medication therapy （TCMT） on immunoglobulin A nephropathy nephropathy （IgAN）. Methods We identified eligible studies in either English or Chinese published up to March 31, 2015 by searching Embase, Pubmed, China Biology Medicine disc（CBM）, Chinese National Knowledge Infrastructure （CNKI）, etc. The quality of selected randomized controlled trails or prospective controlled trails that treated IgA nephropathy with TCMT was assessed and meta-analyses were conducted by using Stata statistical software （version 13.0）. Results Six studies were ultimately enrolled in this metaanalysis, including 3 prospective controlled trails and 3 randomized controlled trails. ①The overall efficacy of TCMT in patients with IgAN： three studies witha total of 224 patients were included, involving 134 patients in TCMT group and 90 patients in medication therapy group. Pooling results of metaanalysis indicated that TCMT was statistically significantly superior to medication therapy alone （ OR = 2.68,95 ; CI = 1.47-4.90, P = 0. 001）. ②The proteinuria remission rate of TCMT in patients with IgAN： 5 studies with a total of 326 patients were included, involving 167 patients in TCMT group and 159 patients in medication therapy group. Meta--analysis showed significant difference between the two groups （ OR = 4.38,95% CI = 2.67-7.20, P d0. 001）. ③The remission rate of erythrocyte of TCMT with IgAN： five studies with a total of 326 patients were included,involving 167 patients in TCMT group and 159 patients in medication therapy group. Meta-analysis also indicated that the difference was statistically significant between the two groups （ OR = 3.90,95; CI = 1.38-11.07, P = 0.01）. Conclusion Compared with the single medication therapy, our study indicated that the TCMTean improve the complete remission of IgAN, proteinuria remission rate and the remission rate of erythroeyte.

关 键 词：肾小球肾炎 IGA 扁桃体切除术 META分析 

分 类 号：R692.31[医药卫生—泌尿科学]