预防性用药对非溶血性输血反应影响的meta分析  

Effect of prophylactic medication on febrile non-hemolytic transfusion reaction:a meta-analysis

作　　者：李双华[1] 李振华 刘春永 LI Shuanghua;LI Zhenhua;LIU Chunyong(The First Department of Hepatology,Zhujiang Hospital of Southern Medical University,Guangdong Province,Guangzhou510282,China;Department of General Surgery,the Second People’s Hospital of Xiping County in Henan Province,Henan Province,Zhumadian463900,China;Department of Basic Medicine,Zhaoqing Medical College,Guangdong Province,Zhaoqing526020,China)

机构地区：[1]南方医科大学珠江医院肝胆一科,广东广州510282 [2]河南省西平县第二人民医院普外科,河南驻马店463900 [3]肇庆医学高等专科学校基础医学部,广东肇庆526020

出　　处：《中国医药导报》2021年第32期117-121,共5页China Medical Herald

基　　金：广东省医学科学技术研究基金项目(A2019086)。

摘　　要：目的探讨分析输血前预防用药对发热及过敏性输血反应发生率的影响。方法收集PubMed,EmBase,The Cochrane Library,中国期刊全文数据库、维普、万方数据库,CBM建库至2020年10月所发表的有关输血前预防用药的临床对照试验,将其分为输血前预防用药组和对照组(输血前不进行预防性用药或使用安慰剂),由两名研究者按照系统评价质量评价标准进行方法学质量评价,提取数据,并用RevMan 5.3软件进行meta分析。结果最终纳入12篇文献。结果显示:输血前预防用药组较对照组发热反应的发生率明显降低,差异有统计学意义(OR=0.70,95%CI:0.55~0.88,P=0.002)。输血前预防用药组较对照组过敏反应的发生率比较,差异无统计学意义(OR=0.87,95%CI:0.62~1.62,P=0.42)。漏斗图显示纳入文献研究无发表偏倚。结论输血前预防性用药能够降低发热反应的发生率,但不能降低过敏反应的发生率。但结论尚需高质量的随机对照试验支持。Objective To investigate and analyze the effect of prophylactic medication before transfusion on the incidence of fever and allergic blood transfusion reaction.Methods Clinical controlled trials on prophylactic medication before transfusion published in PubMed,EmBase,The Cochrane Library,China National Knowledge Internet,China Science and VIP,WanFang Data base,and CBM from inception to October 2020 were collected.They were divided into prophylactic medication before transfusion group and control group(no prophylactic medication or placebo was administered before transfusion).Two researchers conducted methodological quality evaluation according to the systematic evaluation quality evaluation standard,extracted data,and performed meta-analysis with RevMan 5.3 software.Results Twelve articles were included.The results showed that the incidence of fever was significantly lower in the prophylactic medication before transfusion group than in the control group,and the difference was statistically significant(OR=0.70,95%CI:0.55-0.88,P=0.002).There was no significant difference in the incidence of allergic reaction between the prophylactic medication before transfusion group and the control group(OR=0.87,95%CI:0.62-1.62,P=0.42).Funnel plot showed that there was no publication bias in the included literature.Conclusion Prophylactic medication before transfusion can reduce the incidence of febrile reaction,but not allergic reaction.However,the conclusions need to be supported by high-quality randomized controlled trials.

关 键 词：输血 预防性用药 过敏反应 非溶血性发热反应 META分析 

分 类 号：R457.13[医药卫生—治疗学]