替考拉宁与万古霉素治疗革兰氏阳性菌感染的临床疗效和安全性对比的Meta分析  

Effectiveness and safety of teicoplanin versus vancomycin for the treatment of gram-positive bacterial infections:Meta-analysis of randomised controlled trials

作　　者：梁蓓蓓[1] 倪文涛[2] 王瑾[1] 杨德青 江学维[1] 曾宪涛[4] 王睿[1] 刘又宁[2] 

机构地区：[1]中国人民解放军总医院药物/器械临床试验中心,北京100853 [2]中国人民解放军总医院呼吸科,北京100853 [3]大理大学药学与化学学院,云南大理671000 [4]武汉大学循证与转化医学中心,武汉430071

出　　处：《中国临床药理学杂志》2017年第2期176-180,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的评价替考拉宁与万古霉素治疗革兰氏阳性菌感染的临床疗效与安全性。方法检索Pub Med、Em Base、The Cochrane Library、中国生物医学文献数据库、中国知网、维普和万方数据库中有关替考拉宁与万古霉素治疗革兰氏阳性菌感染的随机对照试验(RCT),截至2015年11月。用Rev Man 5.3软件进行分类整理,对治疗革兰氏阳性菌感染的有效率、细菌清除率和药物不良反应发生率、肾毒性发生率和全因死亡率进行分析。结果共纳入45个RCT,共3645例革兰氏阳性菌感染的患者。Meta分析结果显示,替考拉宁组与万古霉素组的有效率分别为79.19%和78.71%,细菌清除率分别为86.81%和85.39%,全因死亡率分别为10.47%和10.60%,差异均无统计学意义(P>0.05);但替考拉宁组与万古霉素组的全部药物不良反应发生率9.28%和16.70%,肾毒性发生率分别为3.15%和8.54%,差异均有统计学意义(P<0.01)。结论替考拉宁治疗革兰氏阳性菌感染的临床疗效与万古霉素相似,但药物不良反应的发生率、肾毒性的发生率均低于万古霉素,安全性更好。Objective To evaluate the effectiveness and safety of teicoplanin and vancomycin in the treatment of gram- positive bacterial infections. Methods Pub Med, EMbase, the Cochrane Library, CBM,CNKI,VIP and Wanfang were searched to identify relevant randomized controlled trial（ RCTs） of teicoplanin and vancomycin in the treatment of Gram- positive bacterial infections before November,2015. The Meta-analysis was performed using Rev Man 5. 3 software to evaluate the clinical cure,microbiological cure,adverse events,nephrotoxicity and mortality of two treatment groups. Results A total of 45 RCTs（ 3645 patients） were included. The results of meta- analysis showed that there was no significant difference（ P〉0. 05） in the clinical cure,microbiological cure and mortality. Total adverse events and nephrotoxicity were at lower risk（ P〈0. 01） in the teicoplanin group than that in the vancomycin group. The clinical cure,microbiological cure,mortality,the incidence of adverse effects and nephrotoxicity were 79. 19% /78. 71%,86. 81% /85. 39%, 10. 47% /10. 60%, 9. 28% /16. 70%, 3. 15% /8. 54% for teicoplanin or vancomycin group. Conclusion Teicoplanin and vancomycin are both effective in treating gram- positive infections,however the incidence of adverse effects and nephrotoxicity in the teicoplanin group was lower than that in the vancomycin group.

关 键 词：替考拉宁 万古霉素 革兰氏阳性菌 META分析 随机对照试验 

分 类 号：R978.1[医药卫生—药品]