地拉罗司对比去铁胺治疗重型地中海贫血患者铁过载的Meta分析  

Deferasirox Versus Deferoxamine in the Treatment of Thalassemia Major: A Meta-analysis

作　　者：许金云 王勇 冯雪连 张锐波 顾教伟 XU Jinyun;WANG Yong;FENG Xuelian;ZHANG Ruibo;GU Jiaowei(Department of Pediatrics,Taihe Hospital,Hubei University Of Medicine,Shiyan 442000,China)

机构地区：[1]湖北省十堰市太和医院(湖北医药学院附属医院)儿科,十堰442000

出　　处：《医药导报》2020年第3期400-404,共5页Herald of Medicine

摘　　要：目的系统评价地拉罗司对比去铁胺治疗重型地中海贫血患者铁过载的疗效及安全性。方法检索Pubmed、Embase、Cochrane library、中国知网、万方数据库、中国生物医学文献数据库及维普数据库,时间为建库至2017年12月。获取地拉罗司对比去铁胺治疗重型地中海贫血的随机对照研究,采用RevMan 5.3版Meta分析软件对原始研究数据进行Meta分析。结果通过文献检索及筛选,共10篇文献纳入本次研究,其中中文2篇,英文8篇。纳入研究的文献整体质量不高。观察期内地拉罗司与去铁胺在降低铁蛋白[MD=296.61,95%CI(-13.64,606.86),P=0.06]、肝脏铁过载下降水平[SMD=0.25,95%CI(-0.41,0.91),P=0.46]方面均差异无统计学意义,不良反应[RR=0.48,95%CI(0.09,2.63),P=0.4]及病死率[RR=0.96,95%CI(0.85,1.08),P=0.52]差异无统计学意义。结论地拉罗司治疗重型地中海贫血铁过载的疗效及安全性在短期内与去铁胺相当,远期疗效及安全性有待大样本随机对照研究评估。Objective To evaluate the effectiveness and safety of deferasirox versus deferoxamine in the treatment of thalassemia major patients. Methods Systematically searched online databases up to December 2017, the online databases including Pubmed, Embase,Cochrane library, CNKI, Wanfang, China biomedical literature database and VIP database. Randomized controlled trails on deferasirox versus deferoxamine for thalassemia major treatment were included in the study. The original research data were analyzed by RevMan 5.3. Results Through literature retrieval and screening,a total of 10 articles were included in this study,there were 2 Chinese and 8 English literature. The quality of the included studies in this article was not high. In observation period, the changes of serum ferritin [MD=296.61,95%CI(-13.64,606.86),P=0.06] and liver iron concentrate [SMD=0.25,95%CI(-0.41,0.91),P=0.46] were not statistically significant between deferasirox and deferoxamine group. There were no statistical significance in adverse reactions [RR=0.48,95%CI(0.09,2.63),P=0.4] and mortality [RR=0.96,95%CI(0.85,1.08),P=0.52] between two group. Conclusion Deferasirox is as effective and safety as deferoxamine for the treatment of thalassemia major iron overload in the short term. The long-term efficacy and safety of deferasirox need to be to evaluated by more randomized controlled trails.

关 键 词：地拉罗司 去铁胺 地中海贫血 铁过载 META分析 

分 类 号：R973.3[医药卫生—药品] R969[医药卫生—药学]