耐碳青霉烯类肺炎克雷伯菌感染患者的全因死亡率分析  

Analysis of the all-cause mortality of carbapenem-resistant Klebsiella pneumoniae infections

作　　者：薛娟[1] 谢敏[2] 周婷[3] XUE Juan;XIE Min;ZHOU Ting(a Key Laboratory of Medical Information Research（Central South University）,College of Hunan Province;b.Surgery Cente;c Department of Urology,The Third Xiangya Hospital of Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院医学信息研究湖南省普通高等学校重点实验室(中南大学),长沙410013 [2]中南大学湘雅三医院手术中心,长沙410013 [3]中南大学湘雅三医院泌尿外科,长沙410013

出　　处：《中国临床药理学杂志》2018年第18期2220-2223,共4页The Chinese Journal of Clinical Pharmacology

基　　金：湖南省科技厅重点研发计划课题基金资助项目(2016JC2063)

摘　　要：目的分析耐碳青霉烯类肺炎克雷伯菌(CRKP)感染患者的全因死亡率。方法用循证学方法,系统检索PubMed、EMBase、Web of Knowledge数据库、中国生物医学文献数据库、中国期刊全文数据库、万方数据库、维普中文科技期刊数据库,文献检索时间建库至2018年4月,纳入分析CRKP感染患者全因死亡率的研究,用Rev Man 5.3软件对患者死亡率进行Meta分析。结果共检出132篇文献,最终纳入22项研究,纳入患者3071例,其中试验组1154例(CRKP感染),对照组1917例。Meta分析结果显示,CRKP感染患者和无CRKP感染患者的全因死亡率分别为46.10%(532例/1154例)和22.59%(433例/1917例),CRKP血流感染患者和无CRKP血流感染患者的全因死亡率分别为46.41%(226例/487例)和17.49%(159例/909例),CRKP感染移植患者和无CRKP感染移植患者的全因死亡率分别为53.03%(35例/66例)和15.01%(53例/353例),差异均有统计学意义(P<0.001,P<0.01)。结论 CRKP感染的移植患者较非CRKP感染的患者的死亡率高,由于纳入研究样本量较小,质量一般,该结论尚需高质量的临床对照研究进一步验证。Objective To assess the all-cause mortality in patients infected by carbapenem-resistant Klebsiella pneumoniae（ CRKP）.Methods Use evidence-based methods to collect data from Pub Med,EMBase,Web of knowledge database,CNKI,CBM,Wanfang and VIP databases（ from establishment to April,2018）. Controlled trials about the outcome of CRKP infections were collected,and Meta-analysis concerning patient mortality were performed by RevMan 5. 3 software.Results A total of 132 matched articles were found and 22 studies were included into this research,3071 patients including 1154 CRKP infection patients（ treatment group） and 1917 controls were involved in this study.Meta-analysis showed that the all-cause mortalities of CRKP infection patients and non-CRKP infection patients were 46. 10%（ 532 cases/1154 cases） and 22. 59%（ 433 cases/1917 cases） respectively. In blood infection patients,the all-cause mortalities of CRKP infection patients and non-CRKP infection patients were 46. 41%（ 226 cases/487 cases） and 17. 49%（ 159 cases/909 cases） respectively. And in transplant patients,the all-cause mortalities of CRKP infection patientsand non-CRKP infection patients were 53. 03%（ 35 cases/66 cases） and 15. 01%（ 53 cases/353 cases） respectively. All differences were statistically significant（ P〈0. 001,P〈0. 01）. Conclusion The mortality of CRKP infection transplant patients is significantly higher than that of non-CRKP infection transplant patients. Because of the limited sample size and reference quality,these conclusions need to be supported by larger and high quality controlled clinical trial.

关 键 词：耐碳青霉烯类肺炎克雷伯菌 全因死亡率 移植患者 META分析 

分 类 号：R978.1[医药卫生—药品]