利奈唑胺联合抗结核药物治疗结核性脑膜炎疗效和安全性的Meta分析  

Meta-analysis of efficacy and safety of linezolid combined with antituberculosis drugs in treatment of tuberculosis meningitis

作　　者：黄继康 刘斌[1] HUANG Jikang;LIU Bin(Infectious Disease Department,The Affiliated ShunDe Hospital of Ji Nan University,Foshan 528000,China)

机构地区：[1]暨南大学附属顺德医院感染科,广东佛山528000

出　　处：《药物评价研究》2021年第1期179-188,共10页Drug Evaluation Research

摘　　要：目的系统评价利奈唑胺联合抗结核药物治疗结核性脑膜炎的临床疗效和安全性。方法检索PubMed、Cochrane Library、EMbase、Web of science、中国生物医学数据库(CBM)、中国学术期刊全文数据库(CNKI)、万方数据库、维普数据库等国内外数据库,搜索发表于2020年7月13日前的关于利奈唑胺联合抗结核药物治疗结核性脑膜炎的临床随机对照试验(RCT)。由2位研究者提取文献资料及进行方法学质量评价,利用Revman 5.2和STATA 10.0软件进行Meta分析。结果共纳入17篇RCTs,包含1196例患者。Meta分析结果显示:利奈唑胺联合抗结核药治疗结核性脑膜炎的有效率高于对照组(OR=3.53,95%CI=2.09~5.95,P<0.05);联合治疗4周后,试验组脑脊液压力(SMD=-50.79,95%CI=-53.86~47.72,P<0.05)指标和格拉斯哥昏迷指数评分(SMD=1.22,95%CI=0.97~1.48,P<0.05)优于对照组;在不良反应方面,4周内利奈唑胺联合抗结核药治疗组的不良反应发生率与对照组近似(RR=1.12,95%CI=0.90~1.38,P=0.32)。结论当前证据表明利奈唑胺联合抗结核药物治疗结核性脑膜炎有较好的临床疗效,不良反应发生率与对照组相近,且可防可控,故该药用于治疗结核性脑膜炎值得临床推广应用。Object To systematically evaluate the efficacy and security of treating Tuberculous Meningitis by using linezolid combined with antituberculosis drugs.Methods Such databases as PubMed,Cochrane Library,EMBASE,Web of science,CNKI,CBM,VIP and Wanfang Database,were searched to collect randomized controlled trials(RCT)concerning linezolid combined with antituberculosis drugs for treating tuberculous meningitis published from the emergence of these databases to 13 th July 2020.There were two researchers screening the studies,extracting the data and assessing the methodology quality.Revman 5.2 and STATA 10.0 was used to execute the meta-analysis.Results A total of 17 RCTs involving 1196 patients were included.Meta-analysis showed that the effective rate of observation group with linezolid plus antituberculosis drugs was higher than control group(OR=3.53,95%CI=2.09 to 5.95,P<0.05).After four-week treatment with linezolid plus antituberculosis drugs,there was a significant improvement between observation group and control group in indexes of cerebrospinal fluid pressure(SMD=-50.79,95%CI=-53.86 to 47.72,P<0.05).and GCS score(SMD=1.22,95%CI=0.97 to 1.48,P<0.05).Moreover,in terms of adverse reactions rate,group with Linezolid combined Antituberculosis Drugs was similar to that in control group.Conclusion As is showed in these evidences,compared to antituberculosis drugs,treating tuberculous meningitis with linezolid plus antituberculosis drugs has a better clinical therapeutic effect.The incidence of adverse reactions of this group is similar to the control group,which can be properly prevented and controlled.Thus,treating tuberculous meningitis with linezolid pulsing antituberculosis drugs is worthy to popularization and application.

关 键 词：利奈唑胺 结核性脑膜炎 临床疗效 安全性 META分析 

分 类 号：R978.3[医药卫生—药品]