泼尼松联合硫唑嘌呤治疗自身免疫性肝炎疗效和安全性的Meta分析
Meta-analysis of the efficacy and safety of prednisone in combination with azathio-prine in the treatment of autoimmune hepatitis
杨秀英 1党小红 2姜洋1
作者信息
- 1. 山西医科大学第一临床医学院,山西 太原 030000
- 2. 山西医科大学第一医院消化内科
- 折叠
摘要
目的 对泼尼松联合硫唑嘌呤(PRED+AZA)治疗自身免疫性肝炎(autoimmune hepatitis,AIH)进行 Meta 分析,以评估标准治疗的疗效及安全性.方法 检索 PubMed、EmBase、Cochrane 图书馆、CNKI、CBM、万方及维普数据库中关于 PRED+AZA 治疗AIH的随机对照试验.对纳入的文献进行质量评价.提取文献中 AIH 患者治疗后的完全缓解率、生化缓解率、不良反应发生率和死亡率,采用 RevMan 5.3 软件进行统计学分析.结果 共纳入 11 篇文献,其中英文文献 7 篇,中文文献 4 篇.Meta 分析显示:对照组治疗 AIH的完全缓解率比 PRED+AZA组高(RR=0.79,95%CI:0.67～0.94,Z= 2.69,P<0.05).亚组分析显示,单用 PRED 治疗 AIH的完全缓解率与 PRED+AZA比较,差异无统计学意义(RR= 0.81,95%CI:0.54～1.23,Z= 0.97,P>0.05),Bude+AZA 治疗AIH的完全缓解率比 PRED+AZA高(RR=0.77,95%CI:0.63～0.93,Z=2.71,P<0.05);与对照组相比,PRED+AZA 治疗 AIH 的生化缓解率和不良反应发生率较高,死亡率较低,但差异均无统计学意义(P>0.05).结论 替代治疗 AIH 的完全缓解疗效优于PRED+AZA,但生化缓解、不良反应发生和死亡情况无明显差异.单用 PRED 治疗 AIH 的完全缓解疗效与 PRED+AZA 相当,而Bude+AZA治疗 AIH的完全缓解疗效优于 PRED+AZA.
Abstract
Objective To evaluate the efficacy and safety of PRED+AZA treatment for autoimmune hepatitis(AIH)through Meta-analysis.Methods Randomised controlled trials of PRED+AZA for AIH in PubMed,EmBase,Cochrane Library,CNKI,CBM,WanFang and VIP databases were searched.The quality of the included literature was evalua-ted.The complete remission rate,biochemical response rate,incidence of adverse events and mortality of patients trea-ted in the literature were extracted and statistically analysed using RevMan 5.3 software.Results A total of 11 publica-tions were included,7 in English and 4 in Chinese.Meta-analysis showed that the control group had a higher rate of complete remission rate for AIH than PRED+AZA group(RR=0.79,95%CI:0.67-0.94,Z=2.69,P<0.05).Sub-group analysis showed no statistically significant difference in complete remission rate for AIH with PRED alone versus PRED+AZA(RR=0.81,95%CI:0.54-1.23,Z=0.97,P>0.05),and higher complete remission rate for AIH with Bude+AZA than PRED+AZA(RR=0.77,95%CI:0.63-0.93,Z=2.71,P<0.05).Compared to the control group,the biochemical remission rate,incidence of adverse events and mortality were not statistically significant(P>0.05).Conclusion The complete remission efficacy of alternative treatments for AIH is superior to that of PRED+AZA,but there are no significant differences in biochemical remission,occurrence of adverse events,or death.The complete re-mission efficacy of PRED alone for the treatment of AIH is comparable to that of PRED+AZA,whereas the complete re-mission efficacy of Bude+AZA for the treatment of AIH is superior to that of PRED+AZA.
关键词
泼尼松/硫唑嘌呤/自身免疫性肝炎/Meta分析Key words
Prednisone/Azathioprine/Autoimmune hepatitis/Meta-analysis引用本文复制引用
基金项目
中华国际科学交流基金会(Z2020LSXD05)
出版年
2024
NETL
NSTL
维普
万方数据