左氧氟沙星联合常规四联化疗方案治疗复治涂阳肺结核疗效及安全性的Meta分析  

Clinical efficacy and safety of levofloxacin combined with conventional quadruple chemotherapy regimen for retreated smear positive pulmonary tuberculosis:a Meta-analysis

作　　者：李晋 彭标 胡爱民[1] 粟仲锐 雷明盛 LI Jin;PENG Biao;HU Aimin;SU Zhongrui;LEI Mingsheng(Jishou University School of Medicine,Hunan Province,Jishou 416000,China;不详)

机构地区：[1]吉首大学医学院,湖南省吉首市416000 [2]南华大学附属长沙中心医院,长沙市410000 [3]湖南省张家界市人民医院,427000 [4]吉首大学张家界学院,湖南省张家界市427000

出　　处：《临床合理用药杂志》2023年第21期1-5,13,共6页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的采用Meta分析法评价左氧氟沙星联合常规四联化疗方案治疗复治涂阳肺结核的疗效及安全性。方法计算机检索中国知网、万方数据知识服务平台、维普网等中文数据库中公开发表的左氧氟沙星联合常规化疗方案治疗复治涂阳肺结核的相关文献,时间限定为建库起至2022年8月。对照组采用利福平+异烟肼+吡嗪酰胺+乙胺丁醇常规化疗方案,试验组在对照组基础上加用左氧氟沙星。提取纳入文献的资料,采用Cochrane评价法评价纳入文献的质量,采用Stata MP 15及RevMan 5.3软件进行Meta分析。结果最终纳入23篇文献,共包含1793例患者,各文献的选择偏倚均为低风险。Meta分析结果显示,试验组总有效率[RR=3.66,95%CI(2.78,4.82)]、痰菌转阴率[RR=1.33,95%CI(1.25,1.41)]、空洞闭合率[RR=1.50,95%CI(1.31,1.71)]、病灶总吸收率[RR=1.28,95%CI(1.21,1.36)]高于对照组(P<0.05),不良反应发生率低于对照组[RR=0.46,95%CI(0.34,0.60),P<0.05]。漏斗图结果显示,报告痰菌转阴率、病灶总吸收率的文献散点左右分布不均匀,提示可能存在发表偏倚;报告总有效率、不良反应发生率的文献散点左右分布均匀,提示发表偏倚可能性较小。结论左氧氟沙星联合常规四联化疗方案治疗复治涂阳肺结核安全有效。Objective To evaluate the clinical efficacy and safety of levofloxacin combined with conventional quadruple chemotherapy regimen for retreated smear positive pulmonary tuberculosis by Meta-analysis method.Methods The relevant literatures of levofloxacin combined with conventional quadruple chemotherapy regimen for retreated smear positive pulmonary tuberculosis in Chinese databases such as CNKI,Wanfang Data,VIP and so on,in which the time limited was from the establishment of databases to August 2022.The control group was adopted the conventional chemotherapy of rifampicin+isoniazid+pyrazinamide+ethambutol,while the experimental group was added levofloxacin on the basis of the control group.Extracted information from the included literatures and evaluated the quality using the Cochrane evaluation method.Meta-analysis was carried out by using Stata MP 15 and RevMan 5.3 software.Results Finally,23 literatures were included,with a total of 1793 patients,and the selection bias of each literature was low risk.Meta-analysis results showed that,the total effective rate[RR=3.66,95%CI(2.78,4.82)],sputum negative conversion rate[RR=1.33,95%CI(1.25,1.41)],cavity closure rate[RR=1.50,95%CI(1.31,1.71)]and total lesion absorption rate[RR=1.28,95%CI(1.21,1.36)]in the experimental group were higher than those in the control group(P<0.05),the incidence of adverse reactions in the experimental group was lower than that of the control group[RR=0.46,95%CI(0.34,0.60),P<0.05].The literatures scatter plots of sputum negative conversion rate and total lesion absorption rate exhibited uneven distribution,suggested possible presence of publication bias;the literatures scatter plots of the total effective rate and incidence of adverse reactions demonstrated uniform distribution,suggested lower likelihood of publication bias.Conclusion Levofloxacin combined with conventional quadruple chemotherapy regimen can effectively and safely treat patients with retreated smear positive pulmonary tuberculosis.

关 键 词：复治涂阳肺结核 左氧氟沙星 常规四联化疗方案 META分析 

分 类 号：R521[医药卫生—内科学]