抗肿瘤坏死因子抗体预防克罗恩病术后复发的Meta分析  

Anti-tumor necrosis factor antibody in preventing postoperative recurrence of Crohn’s disease:A meta analysis

作　　者：何孝明 黄宣[2] 倪栋琼 HE Xiaoming;HUANG Xuan;NI Dongqiong(Department of Emergency,Zhejiang Medical&Health Group Hangzhou Hospital,Hangzhou 310022,China)

机构地区：[1]浙江省医疗健康集团杭州医院急诊科,浙江杭州310022 [2]浙江中医药大学附属第一医院消化内科

出　　处：《全科医学临床与教育》2020年第5期391-396,共6页Clinical Education of General Practice

基　　金：国家自然科学基金(81673745)。

摘　　要：目的 评价抗肿瘤坏死因子抗体(anti-TNF)在预防克罗恩病术后复发的有效性以及安全性.方法 计算机检索Pubmed、Embase、Cochrane library、中国知网以及万方数据库中关于anti-TNF预防克罗恩病术后复发的随机对照试验,评价纳入研究质量,并用Revman 5.3软件进行统计学分析.结果 共纳入7个随机对照试验,计546例患者,其中anti-TNF组264例、对照组282例.Meta分析结果显示:anti-TNF用于克罗恩病术后内镜复发率的RR值为0.45(95%CI 0.31~0.67,P<0.05),临床复发率的RR值为0.37(95%CI 0.18~0.75,P<0.05),组织缓解率的RR值为4.39(95%CI 1.75~10.97,P<0.05),内镜缓解率的RR值为4.12(95%CI 2.51~6.76,P<0.05);临床缓解率的RR值为1.43(95%CI 0.93~2.19,P>0.05);不良反应发生率的RR值为0.80(95%CI 0.61~1.06,P>0.05).结论 anti-TNF用于克罗恩病术后,内镜复发率和临床复发率明显下降,组织缓解率、内镜缓解率明显提高,临床缓解率和不良反应发生率无明显改善.Objective To evaluate the efficacy and safety of anti-tumor necrosis factor antibody(anti-TNF)in reducing postoperative recurrence of Crohn's disease.Methods Randomized controlled trials(RCT)of anti-TNF in preventing postoperative recurrence of Crohn's disease in Pubmed,Embase,Cochrane library,CNKI and wanfang databases were searched by computer.The quality of the included studies was evaluated,and statistical analysis was performed with Revman5.3 software.Results A total of 546 patients were included in 7 randomized controlled trials,including 264 in the anti-TNF group and 282 in the control group.Meta analysis results showed that the RR value of the endoscopic recurrence rate was 0.45(95%CI 0.31-0.67,P<0.05).The RR value of clinical recurrence rate was 0.37(95%CI 0.18-0.75,P<0.05).The RR value of tumor remission rate was 4.39(95%CI 1.75-10.97,P<0.05).The RR value of endoscopic remission rate was 4.12(95%CI 2.51-6.76,P<0.05).The RR value of clinical remission rate was 1.43(95%CI 0.93-2.19,P>0.05).The RR value of incidences of adverse reactions was 0.80(95%CI 0.61-1.06,P>0.05).Conclusion The endoscopic and clinical recurrence rates after anti-TNF antibody given in the patients with Crohn’s disease are significantly reduced,the tissue and endoscopic remission rates are significantly increased,and there is no significant improvement of the clinical remission rate and the incidence of adverse reactions.

关 键 词：抗肿瘤坏死因子抗体 英夫利西单抗 阿达木单抗 克罗恩病 术后复发 不良反应 META分析 

分 类 号：R574.62[医药卫生—消化系统]