重组人干扰素α1b治疗儿科常见病毒性疾病安全性的  

Meta - analysis of safety of recombinant human interferon α1b therapy for viral diseases

作　　者：杨丽华[1] 张国成[1] 邓跃林[1] 张垚[1] 

机构地区：[1]第四军医大学附属西京医院儿科,西安710032

出　　处：《中华实用儿科临床杂志》2017年第10期771-776,共6页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的系统评价重组人干扰素α1b（rhIFNα1b）治疗儿科常见病毒性疾病的安全性，为临床治疗提供循证医学参考。方法检索PubMed文献检索服务系统、科学引文索引数据库、中国知网、万方数据库中关于rhIFNα1b治疗儿童病毒性疾病的随机对照试验（RCT），进行文献Meta分析。结果共纳入19个RCTs，合计2 731例患儿。Meta分析结果显示，rhIFNα1b治疗组1 437例，发生不良反应59例（4.1%）；对照组1 294例中有79例（6.1%）发生不良反应，rhIFNα1b治疗组不良反应发生率低于对照组，总效应Z＝2.18（P＝0.03），RR＝0.71（95%CI：0.52～0.97）。rhIFNα1b治疗组和对照组不良反应发生率在肌肉注射亚组中无区别，总效应Z＝0.78（P＝0.43），RR＝0.86（95%CI：0.58～1.26）。在雾化吸入亚组，rhIFNα1b治疗组不良反应发生率低于对照组，总效应Z＝2.44（P＝0.01），RR＝0.53（95%CI：0.32～0.88）。rhIFNα1b治疗组和对照组的不良反应在消化道症状[Z＝2.20 （P＝0.03），RR＝0.60（95%CI：0.39～0.95）]、神经系统症状[Z＝2.09（P＝0.04），RR＝4.28（95%CI： 1.10～16.72）]方面差异均有统计学意义。结论与其他抗病毒药物比较，rhIFNα1b治疗儿科常见病毒性疾病安全性好，其不良反应发生率低，雾化吸入rhIFNα1b较肌肉注射的不良反应发生率更低。Objective To systematically assess the safety of recombinant human interferon α1b（rhIFNα1b） as therapy for viral diseases in children, so as to provide on evidence-based medicine for the clinical treatment.Methods Randomized controlled trails （RCTs） of rhIFNα1b for viral diseases in children were investigated through PubMed literature retrieval service system, Science Citation Index, China National Knowledge Infrastructure, WanFang Database; RCTs were selected according to the inclusion and exclusion criteria.Related data were extracted and the Meta-analysis was performed.Results Nineteen RCTs were involved, including 2 731 patients.In the overall, 59/1 437 cases （4.1%） in the rhIFNα1b treatment group and 79/1 294 cases （6.1%） in the control group had adverse reactions.The Meta-analysis revealed that in the overall and in atomization inhalation subgroup, the incidence of adverse reactions was significantly lower in the rhIFNα1b treatment group than that in the control group[Z=2.18（P=0.03）, RR=0.71（95%CI： 0.52-0.97）; Z=2.44（P=0.01）, RR=0.53（95%CI： 0.32-0.88）]. But, there was no significant difference in the incidence of adverse reactions between the rhIFNα1b treatment group and the control group in intramuscular injection subgroup, and the test for overall effect was Z=0.78（P=0.43）, RR=0.86（95%CI： 0.58-1.26）. The incidence of adverse reactions of the control group was significantly higher than that of the rhIFNα1b treatment group in gastrointestinal adverse reaction [Z=2.20（P=0.03）, RR=0.60（95%CI： 0.39-0.95）], and the incidence of adverse reactions of the rhIFNα1b treatment group was significantly higher than that of the control group in nervous system symptoms [Z=2.09（P=0.04）, RR=4.28（95%CI： 1.10-16.72）].Conclusion Compared with other antiviral drugs, the treatment of pediatric common viral diseases with rhIFNα1b has good safety, low incidence of adverse reactions, and the incidence of adverse reactions through atomization inhalation can b

关 键 词：重组人干扰素Α1B 病毒性疾病 儿科 安全性 META分析 

分 类 号：R725.1[医药卫生—儿科]