腔内应用重组人血管内皮抑制素联合铂类治疗恶性胸腹腔积液疗效及安全性的Meta分析  

Efficacy and safety of intra-pleural injection of recombinant human endostatin and platinum in treatment of malignant pleural effusion and ascites:a Meta analysis

作　　者：韩丽 曹林 黄娇 杨莉 杨健筌 HAN Li;CAO Lin;HUANG Jiao;YANG Li;YANG Jianquan(Department of Pharmacy,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China;School of Medicine,University of Electronic Science and Technology of China,Chengdu 610054,Sichuan,China)

机构地区：[1]川北医学院附属医院药剂科,四川南充637000 [2]电子科技大学医学院,成都6100540

出　　处：《癌症进展》2021年第14期1437-1441,1512,共6页Oncology Progress

摘　　要：目的采用Meta分析方法评价腔内应用重组人血管内皮抑制素联合铂类治疗恶性胸腹腔积液的疗效及安全性。方法计算机检索The Cochrane Library、PubMed、Embase、CBM、CNKI、维普及万方数据库。对符合纳入标准的研究进行方法学质量评价,并采用RevMan 5.3版软件进行Meta分析。结果共纳入20项研究,包括1571例恶性胸腹腔积液患者。Meta分析结果显示,与胸腹腔灌注铂类单药治疗相比,腔内应用重组人血管内皮抑制素联合铂类治疗可以提高恶性胸腹腔积液的完全缓解率(OR=2.34,95%CI:1.78~3.07,P﹤0.01)、部分缓解率(OR=1.75,95%CI:1.41~2.18,P﹤0.01)、总有效率(OR=3.30,95%CI:2.65~4.11,P﹤0.01),并改善患者的生活质量(OR=2.55,95%CI:1.81~3.61,P﹤0.01)。不良反应方面,与胸腹腔灌注铂类单药治疗相比,腔内应用重组人血管内皮抑制素联合铂类治疗并未增加恶性胸腹腔积液患者胃肠道反应、骨髓抑制、肝功能异常及心率异常的发生率(P﹥0.05)。结论腔内应用重组人血管内皮抑制素联合铂类治疗恶性胸腹腔积液可以提高治疗有效率,改善患者的生活质量,同时并未增加治疗相关不良反应。Objective The purpose of this study was to evaluate the efficacy and safety of intra-pleural injection of re-combinant human endostatin and platinum in treatment of malignant pleural effusion and ascites by Meta-analysis.Meth-od The Cochrane Library,Pubmed,Embase,CBM,CNKI,VIP and Wanfang Database were searched by computer.Methodological quality evaluation was conducted for the studies that met the inclusion criteria,and the Meta-analysis was performed by the Revman 5.3 software.Result A total of 20 studies were included,including 1571 patients with malig-nant pleural effusion and ascites.The Meta-analysis results showed that compared with intraperitoneal perfusion of plati-num monotherapy,intra-pleural injection of recombinant human endostatin and platinum could improve the complete re-mission rate(OR=2.34,95%CI:1.78-3.07,P<0.01),partial remission rate(OR=1.75,95%CI:1.41-2.18,P<0.01),overall efficacy rate(OR=3.30,95%CI:2.65-4.11,P<0.01),and the quality of life(OR=2.55,95%CI:1.81-3.61,P<0.01)of pa-tients with malignant pleural effusion and ascites.In terms of side effects,compared with intraperitoneal perfusion of plat-inum monotherapy,intra-pleural injection of recombinant human endostatin and platinum did not increase the incidence of gastrointestinal reactions,myelosuppression,abnormal liver function and abnormal heart rate in patients with malig-nant pleural effusion and ascites(P>0.05).Conclusion The existing evidence shows that intra-pleural injection of recom-binant human endostatin with platinum in the treatment of malignant pleural effusion and ascites can improve the effec-tive rate and the quality of life of patients,while not increasing the side effects.

关 键 词：重组人血管内皮抑制素 铂类 恶性胸腹腔积液 META分析 

分 类 号：R730[医药卫生—肿瘤]