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莫匹罗星与庆大霉素等药物预防腹膜透析相关感染疗效的Meta分析 被引量：7

Comparison between mupirocin and other drugs as gentamicin for preventing peritoneal dialysis related infections
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摘要 目的通过Meta分析观察庆大霉素等药物对腹膜透析(PD)患者预防出口处感染和腹膜炎是否与莫匹罗星一样有效,希望为预防腹膜透析感染提供更多选择。方法检索MEDLINE,the Cochrane Database,EMBASE,theScience Citation Index等数据库,收集符合纳入标准的随机对照研究(RCT)或自身对照研究。比较莫匹罗星与其他药物在预防出口处感染(ESI)和腹膜炎的差异。结果共有6篇文献6项研究包括537例莫匹罗星组患者和532例对照组患者入选本次分析。应用莫匹罗星组与其他药物组在降低总ESI的风险、总腹膜炎及金黄色葡萄球菌感染所致腹膜炎的风险方面差异均无统计学意义(P分别为0.28、0.06和0.53)。但在对金黄色葡萄球菌所致的ESI分析中,应用莫匹罗星组比其他药物组降低47%由金黄色葡萄球菌感染所致ESI的风险(P=0.02,95%CI:0.10～0.69)。对莫匹罗星和庆大霉素的亚组分析结果与总的分析结果一致,两组在降低总ESI的风险、总腹膜炎及金黄色葡萄球菌感染所致腹膜炎的风险方面差异均无统计学意义(P分别为0.87、0.21和0.31)。但在对金黄色葡萄球菌所致的ESI分析中,应用莫匹罗星组比庆大霉素组降低63%由金黄色葡萄球菌感染所致ESI的风险(P=0.008,95%CI:0.23～0.82)。结论在预防总的ESI和腹膜炎方面并未发现优于莫匹罗星的药物,在金黄色葡萄球菌感染所致的ESI方面,莫匹罗星组要优于其他药物组,所以临床上仍可首选莫匹罗星作为预防用药。 Objective To find out whether there are drugs as effective as mupirocin for prevention of exit-site infection （ESI） and peritonitis in peritoneal dialysis （PD） patients, thus providing more choices for preventing infection clinically. Methods MEDLINE, the Cochrane Database, EMBASE and the Science Citation Index were searched for randomized controlled trials （RCTs） or self controlled studies that met the inclusion criteria. Comparisons between mupirocin and other drugs in prevention of ESI and peritonitis were done. Results Six studies involving a total of 537 patients versus 532 controis were included in the analysis. The overall ESI rates, the total peritonitis rates and the rates of peritonitis due to S. aureus were similar in the two groups （P =0. 28 ,P =0. 06 ,P =0. 31 ）. However,mupirocin decreased the risk by 47% （95% CI：0. 10- 0. 69） in ESI clue to S. aureus. Analyses on subgroups of mupirocin and gentamin groups indicated the same re- suits,and the total ESI rates,the peritonitis rates and the rates of peritonitis due to S. aureus were similar in the two subgroups （P =0. 87 ,P =0. 21 ,P =0. 53）. But mupirocin decreased the risk by 63% （95% CI：0. 23 -0. 82） in ESI due to S. aureus. Conclusion No superior drugs are found in preventing total ESI and PD related peritonitis in patients. But in preventing ESI due to S. aureus, mupirocin is superior to other drugs. Clinically, mupirocin is still recommended as the optimal preventive drug.
作者 张晓群 张维 寿张飞 何强
机构地区 浙江大学医学院附属第一医院肾脏病中心
出处 《中国实用内科杂志》 CAS CSCD 北大核心 2013年第6期464-468,共5页 Chinese Journal of Practical Internal Medicine
关键词 腹膜透析 莫匹罗星 出口处感染 腹膜炎 peritoneal dialysis mupiroein exit-site infection peritonitis
分类号 R459.5 [医药卫生—治疗学]
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参考文献20

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共引文献35

同被引文献81

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引证文献7

二级引证文献19

中国实用内科杂志
2013年 第6期

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