英夫利西单抗和环孢素对激素难治性溃疡性结肠炎疗效及安全性的Meta分析  

Meta-analysis of efficacy and safety of infliximab and ciclosporin in treatmeat of steroid-refractory ulcerative colitis

作　　者：秦岩[1] 谭友文[2] 徐岷[3] QIN Yan TAN You-wen XU Min(School of Medicine, Jiangsu University, Zhenjiang Jiangsu 212013 Department of Liver Disease, Zhenjiang Third Hospital Affilia- ted to Jiangsu University, Zhenjiang Jiangsu 212005 Department of Gastroenterology, the Affiliated Hospital of Jiangsu University, Zhenjiang Jiangsu 212001, China)

机构地区：[1]江苏大学医学院,江苏镇江212013 [2]江苏大学附属镇江三院肝病科,江苏镇江212005 [3]江苏大学附属医院消化内科,江苏镇江212001

出　　处：《江苏大学学报（医学版）》2016年第1期65-70,共6页Journal of Jiangsu University：Medicine Edition

摘　　要：目的：评价抗肿瘤坏死因子英夫利西单抗（infliximab,IFX）和免疫抑制剂环孢素对于激素难治性溃疡性结肠炎疗效及安全性的差异。方法：以infliximab,ciclosporin,ulcerative colitis,randomized controlled trials为检索词,检索Cochrane图书馆、Pubmed、Google、CBM等数据库及Cochrane图书馆临床对照试验数据库。以英夫利西单抗、环孢素、溃疡性结肠炎、随机对照试验为检索词检索万方数据库、中文期刊全文数据库及中国生物医学文献数据库,对纳入文献逐个进行质量评价和资料摄取。检索文献年限为2004年1月至2014年3月。采用Rev Man 5.2软件对数据进行统计分析。结果：共纳入7篇文献,环孢素组治疗3个月结肠切除率明显高于英夫利西单抗组（RR=2.19,95%CI：1.503.20,Z=4.04,P〈0.000 1）;环孢素组治疗12个月结肠切除率明显高于英夫利西单抗组（RR=1.58,95%CI：1.192.09,Z=3.21,P=0.001）;两组用药并发症发生率比较,差异无统计学意义（RR=1.17,95%CI：0.701.95,Z=0.60,P=0.55）。结论：英夫利西单抗治疗激素难治性溃疡性结肠炎的效果优于环孢素,而两种药物使用安全性差异并不明显。Objective ： To evaluate the difference of the efficacy and safety of infliximab and ciclospor- in in treatmeat of steroid-refractory ulcerative colitis. Methods： All relevant studies were searched by Co- chrane library, Pubmed, Google, CNKI, WanFang database and CBMdatebase with the index words of infliximab, ciclosporin, ulcerative colitis, randomized controlled trials, meta analysis. The literature ref- erences of the papers were also included. Evaluated the quality of the paper and absorb the information one by one. Calculated the risk ratio in the Review Manager version 5.2 and process the statistical analy- sis. Results： Overall, 7 papers were included in the Meta-analysis, for the comparison of the results of three-month colectomy rate between infliximab group and ciclosporin group, the rate of ciclosporin group was obviously higher than that of infliximab group （RR =2.19, 95% CI： 1.50 -3.20, Z =4.04, P 〈 0. 000 1 ） ; for the comparison of the results of twelve-month colectomy rate between infliximab group and ciclosporin group, the rate of ciclosporin group was also obviously higher than that of infliximab group （RR = 1.58, 95% CI： 1.19 -2.09, Z =3.21, P =0. 001 ） ; for the comparison of the difference of the medical complication （security）, there is no obvious difference between two groups （RR = 1.17, 95%CI： 0.70 - 1.95, Z =0.60, P = 0.55 ）. Conclusion ： The treatment effects of infliximab to the steroidrefractory ulcerative colitis was better than that of ciclosporin,while the drug safety between them was notobvious.

关 键 词：英夫利西单抗 环孢素 溃疡性结肠炎 随机对照试验 META分析 

分 类 号：R574.62[医药卫生—消化系统]