西那卡塞与甲状旁腺切除术治疗肾性甲旁亢患者疗效的Meta分析  

Meta-analysis of the Efficacy of Cinacalcet and Parathyroidectomy in the Treatment of Renal Hyperparathyroidism

作　　者：温童 王圳 周茹 张欣洲[1] WEN Tong;WANG Zhen;ZHOU Ru;ZHANG Xin-zhou(Department of Nephrology,Shenzhen People's Hospital,the Second Clinical Medical College,Jinan University,Shenzhen 518020,Guangdong,China)

机构地区：[1]暨南大学第二临床医学院深圳市人民医院肾内科

出　　处：《医学信息》2019年第14期78-82,共5页Journal of Medical Information

摘　　要：目的采用Meta分析探讨西那卡塞与甲状旁腺切除术治疗肾性甲旁亢的疗效,为临床上治疗肾性甲旁亢的方案选择提供参考。方法检索PubMed、EMBASE、Cochrane、Webof Science电子数据库,筛选出符合纳入标准的文献,使用Cochrane中心推荐的方法进行文献偏倚风险评估。提取最终纳入文献的相关效应量,使用RevMan5.2软件进行数据合并及分析,评价两种治疗方案的疗效。结果共检出文献1289篇,纳入符合要求文献共5篇,其中1篇RCT,4篇队列研究,共计肾性甲旁亢患者370例。Meta分析结果示,西那卡塞组与甲状旁腺切除术组血甲状旁腺素(MD=135.48,95%CI:-123.85~394.80,P=0.31)、血钙(MD=-0.08,95%CI:-0.27~0.10,P=0.37)、血磷(MD=-0.02,95%CI:-0.16~0.12,P=0.78)、血碱性磷酸酶(MD=56.66,95%CI:-75.42~188.75,P=0.40)比较,差异均无统计学意义(P<0.05)。结论西那卡塞与甲状旁腺切除术治疗肾性甲旁亢相比,在控制血甲状旁腺素、血钙、血磷、血碱性磷酸酶的效果上无差异,疗效相当。Objective To investigate the efficacy of cinacalcet and parathyroidectomy in the treatment of renal hyperparathyroidism with meta-analysis,and to provide a reference for the clinical options for the treatment of renal hyperparathyroidism.Methods PubMed,EMBASE,Cochrane,and Webof Science electronic databases were searched,and the literatures that met the inclusion criteria were screened and the risk of literature bias was assessed using the method recommended by the Cochrane Center.The relevant effect sizes were finally extracted into the literature,and data were combined and analyzed using RevMan 5.2 software to evaluate the efficacy of the two treatment regimens.Results A total of 1289 articles were detected and 5 articles were included in the literature.Among them,1 RCT,4 cohort studies,and 370 patients with renal hyperparathyroidism.Meta-analysis showed that the parathyroid hormone (MD=135.48,95% CI:-123.85-394.80,P=0.31),Blood calcium (MD=-0.08,95% CI:-0.27~0.10,P=0.37),blood phosphorus (MD=-0.02,95% CI:-0.16~0.12,P=0.78),blood alkaline phosphatase (MD=56.66,95% CI:-75.42~188.75,P=0.40),the difference was not statistically significant (P<0.05).Conclusion Cinacalcet has no difference in the control of blood parathyroid hormone,serum calcium,blood phosphorus and blood alkaline phosphatase compared with parathyroidectomy for renal hyperparathyroidism.

关 键 词：西那卡塞 肾性甲旁亢 甲状旁腺切除术 META分析 

分 类 号：R69[医药卫生—泌尿科学]