摘要
目的系统评价利福喷丁与利福平比较治疗肺结核的安全性。方法计算机检索Pub Med、EMbase、The Cochrane Library、CBM、VIP、Wan Fang Data和CNKI数据库,搜集比较利福喷丁与利福平治疗肺结核安全性的随机对照试验(RCT),检索时限截至2017年9月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果共纳入26个RCT,包括3 624例患者。Meta分析结果显示:利福喷丁组的肝功能异常发生率[RR=0.39,95%CI(0.32,0.47),P<0.000 01]、皮疹发生率[RR=0.24,95%CI(0.16,0.37),P<0.000 01]、白细胞下降发生率[RR=0.41,95%CI(0.31,0.54),P<0.000 01]、胃肠道反应发生率[RR=0.46,95%CI(0.37,0.57),P<0.000 01]均低于利福平组,其差异均有统计学意义。结论当前证据表明,与利福平相比,利福喷丁治疗肺结核能够减轻患者的不良反应。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。
Objective To systematically review the safety of rifapentine vs. rifampicin for pulmonary tuberculosis. Methods PubMed, EMbase, The Cochrane Library, CBM, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials （RCTs） of rifapentine vs. rifampicin for pulmonary tuberculosis up to September 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software. Results A total of 26 RCTs involving 3 624 cases were included. The results of meta-analysis showed that the rifapentine group was superior to the rifampicin group on the incidence of abnormal liver function （RR=0.31, 95%CI 0.32 to 0.47, P〈0.000 01）, skin rash occurrence rate （RR=0.24, 95%CI 0.16 to 0.37, P〈0.000 01）, the incidence of leukopenia （RR=0.41, 95%CI 0.31 to 0.54, P〈0.000 01）, and the incidence of gastrointestinal reaction （RR=0.46, 95%CI 0.37 to 0.57, P〈0.000 01） with statistical significance. Conclusions Current evidence shows that compared with rifampicin, rifapentine can effectively reduce the adverse reactions of patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
出处
《中国循证医学杂志》
CSCD
2017年第11期1291-1297,共7页
Chinese Journal of Evidence-based Medicine
关键词
利福喷丁
利福平
肺结核
安全性
随机对照试验
META分析
系统评价
Rifapentine
Rifampicin
Pulmonary tuberculosis
Safety
Randomized controlled trial
Meta-analysis
Systematic review
