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儿童紫癜性肾炎临床研究结局指标的范围综述

Clinical Study Outcome Indicators for Henoch-Schonlein Purpura Nephritis:a Scoping Review

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背景 过敏性紫癜是一种好发于儿童期的血管炎性疾病,部分患儿会累及肾脏,临床上称为紫癜性肾炎.目前不同研究建议的干预措施不尽相同,对于相应干预措施所采用的结局指标存在较大差异.目的 调查分析我国紫癜性肾炎临床研究结局指标现状,为该领域核心结局指标集的建立提供参考依据.方法 系统检索中国知网、中国生物医学文献数据库、维普网、万方数据知识服务平台,PubMed,Cochrane Library,Embase及Web of Science,收集公开发表的紫癜性肾炎相关研究,检索时限均为 2010 年 1 月—2021 年 6 月.中文数据库采用题名或关键词结合主题词的检索策略进行检索,英文数据库采用主题词结合自由词的方式进行检索.由两名研究员按照纳入与排除标准独立筛选文献和提取资料,并对结局指标数据进行处理分析.结果 共纳入紫癜性肾炎的随机对照研究 148 篇,紫癜性肾炎研究结局指标以理化指标为主,症状类指标较少.结局指标出现频次依次为临床疗效(121次,81.76%),不良反应(74次,50.00%),24 h尿蛋白(68 次,45.95%),尿红细胞(43 次,29.05%),复发率(20 次,13.51%).仅 2 篇文献明确区分主要和次要结局指标.结论 国内紫癜性肾炎研究结局指标种类繁多,以理化指标为主,异质性较大.研究关注疗效指标而对不良反应的关注度不足.因此有必要建立紫癜性肾炎临床干预性研究结局指标集,为同类研究选择结局指标及指导临床决策提供参考依据.
Background Henoch-Schonlein purpura is a vascular inflammatory illness that develops in childhood and in some children involves the kidneys,clinically known as Henoch-Schonlein purpura nephritis.Different studies have suggested different interventions,and there is a wide variation in the outcome indicators used for the intervention approaches.Objective To investigate and analyze the current status of clinical research outcome indicators for Henoch-Schonlein purpura nephritis in China,so as to provide a reference basis for the establishment of a core set of outcome indicators in this field.Methods CNKI,CBM,VIP,Wanfang Data,PubMed,Cochrane Library,Embase and Web of Science were systematically searched to collect publicly available Henoch-Schonlein purpura nephritis studies from January 2010 to June 2021.The Chinese databases were searched using the search strategy of title or keywords combined with subject terms,and the English databases were searched using subject terms combined with free words.Two investigators independently screened the literature and extracted information according to the inclusion and exclusion criteria,processed and analyzed the data on outcome indicators.Results A total of 148 randomized controlled trials of Henoch-Schonlein purpura nephritis were included,and the outcome indicators of Henoch-Schonlein purpura nephritis studies were mainly physical and chemical indicators,with fewer symptomatic indicators.The highest frequency of outcome indicators were clinical efficacy(121 times,81.76%),adverse reactions(74 times,50.00%),24-hour urine protein(68 times,45.95%),urinary red blood cells(43 times,29.05%),and recurrence rate(20 times,13.51%).The division between primary and secondary outcome indicators was clearly distinguished in only two articles.Conclusion There are several indicators for the research outcomes of Henoch-Schonlein purpura nephritis in China,primarily physical and chemical variables,with significant variation.The research focuses on efficacy measures but ignores adverse reactions.As a result,it is necessary to establish a set of outcome indicators for clinical intervention studies on Henoch-Schonlein purpura nephritis in order to provide a reference basis for selecting outcome indicators and guiding clinical decision-making in future similar studies.

IgA vasculitis nephritisHenoch-Schonlein purpuraChildOutcome indicatorsSet of outcomesScoping review

佟静涵、吴晓明、孙雅欣、李姝凝、梁琛、董恒、车刚、刘畅、胡艳、刘雅莉

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100045 北京市,国家儿童医学中心首都医科大学附属北京儿童医院

100045 北京市,国家儿童医学中心首都医科大学附属北京儿童医院中医科

100069 北京市,首都医科大学中医药学院

735100 甘肃省嘉峪关市第一人民医院

100045 北京市,国家儿童医学中心首都医科大学附属北京儿童医院临床流行病学与循证医学中心

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紫癜性肾炎 过敏性紫癜 儿童 结局指标 结局指标集 范围综述

北京市研究型病房建设示范单位项目北京市中医药科技发展重点项目首都医科大学"本科生科研创新"项目

BCRW2202101BJZYZD-2023-03XSKY2021337

2024

中国全科医学
中国医院协会

中国全科医学

CSTPCD北大核心
影响因子:2.04
ISSN:1007-9572
年,卷(期):2024.27(29)
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