巨细胞病毒感染和抗病毒治疗对溃疡性结肠炎患者预后影响的meta分析  

Effects of Cytomegalovirus Infection and Antiviral Therapy on Prognosis of Patients With Ulcerative Colitis:A Meta-analysis

作　　者：尹凤荣[1] 魏民华[1] 雷蕾[1,2] 郭金波 霍晓霞[1] 张晓岚[1] YIN Fengrong;WEI Minhua;LEI Lei;GUO Jinbo;HUO Xiaoxia;ZHANG Xiaolan(Department of Gastroenterology,the Second Hospital of Hebei Medical University,Hebei Key Laboratory of Gastroenterology,Hebei Institute of Gastroenterology,Shijiazhuang(050000);Department of Gastroenterology,215 Nuclear Industry Hospital of Shaanxi,Xianyang,Shaanxi Province)

机构地区：[1]河北医科大学第二医院消化内科,河北省消化病重点实验室,河北省消化病研究所,050000 [2]陕西核工业215医院消化内科

出　　处：《胃肠病学》2018年第4期231-237,共7页Chinese Journal of Gastroenterology

摘　　要：背景:溃疡性结肠炎(UC)患者是巨细胞病毒(CMV)感染的高危人群,合并CMV感染可能会加重UC患者的病情进展,抗病毒治疗或许可改善UC患者的预后。目的:系统评价CMV感染以及抗病毒治疗对UC患者预后的影响。方法:计算机检索英文数据库Pub Med、Cochrane Library、Embase以及中文数据库中国知网(CNKI)、万方数据知识服务平台(Wanfang)、中国生物医学文献服务系统(Sino Med)和维普期刊资源整合服务平台(VIP),纳入CMV感染和抗病毒治疗影响UC患者预后的病例对照研究。采用Rev Man 5.3软件对纳入文献行meta分析。结果:共纳入20篇病例对照研究。Meta分析显示CMV感染组的UC患者病情更重(OR=1.62,95%CI:1.13～2.33)、肠道病变范围更广泛(OR=0.63,95%CI:0.43～0.92)、激素依赖/抵抗风险增加(OR=6.13,95%CI:1.98～19.00)、结肠切除风险增加(OR=1.64,95%CI:1.14～2.36)。抗病毒治疗可显著提高合并CMV感染者的早期临床缓解率(OR=2.08,95%CI:1.03～4.17),降低结肠切除风险(OR=2.12,95%CI:1.06～4.22)。结论:CMV感染会加重UC患者的病情、扩大肠道病变范围、增加激素依赖/抵抗、增加结肠切除风险。抗病毒治疗可显著提高UC患者的早期临床缓解率,降低结肠切除风险。Background:Ulcerative colitis(UC)patients are the high risk population of cytomegalovirus(CMV)infection.CMV infection may aggravate the disease progression of UC,and the prognosis of UC patients with CMV infection may be improved by antiviral therapy.Aims:To systematically evaluate the effects of CMV infection and antiviral therapy on prognosis of UC patients.Methods:PubMed,Cochrane Library,Embase,CNKI,Wanfang,SinoMed and VIP database were retrieved to collect the case-control studies studying the effects of CMV infection and antiviral therapy on prognosis of UC patients.Meta-analysis was conducted by RevMan 5.3 software.Results:Twenty case-control studies were enrolled.Meta-analysis showed that UC patients in CMV infection group were more serious(OR=1.62,95%CI:1.13-2.33),and had larger intestinal lesions(OR=0.63,95%CI:0.43-0.92),higher risks of steroid dependence/resistance(OR=6.13,95%CI:1.98-19.00)and colectomy(OR=1.64,95%CI:1.14-2.36).Antiviral therapy for UC patients with CMV infection significantly improved the early clinical remission rate(OR=2.08,95%CI:1.03-4.17),decreased risk of colectomy(OR=2.12,95%CI:1.06-4.22).Conclusions:CMV infection can aggravate the progress of UC,enlarge the extent of intestinal lesion,increase the risks of steriod dependence/resistance and colectomy.Antiviral therapy significantly improves the early clinical remission rate,and decreases the risk of colectomy.

关 键 词：结肠炎 溃疡性 巨细胞病毒 抗病毒治疗 预后 META分析 

分 类 号：R574.62[医药卫生—消化系统]