目的 聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)和重组人粒细胞集落刺激因子(rhG-CSF)是临床中治疗恶性肿瘤化疗后中性粒细胞减少症(CIN)的主要药物,为全面评价二者在疗效和不良反应方面的差异,需要分析现有相关试验研究,以更好地指导临床.方法 对2005年6月至2023年6月发表的收录于PubMed、Embase、Web of Science和中国生物医学文献资料库的中英文文献进行检索.结果 对9项随机对照研究进行比较.结果显示,PEG-rhG-CSF和rhG-CSF干预后CIN发生率比较,差异无统计学意义[n=695,RR=0.49,95％CI(0.24,1.02),P=0.06],提示二者疗效相当.而二者在不良反应发生率上比较,差异有统计学意义[n=695,RR=0.66,95％CI(0.55,0.78),P＜0.000 01].两项对比可信度方面均表现良好,无发表偏倚和异质性,Egger's 结果分别为[95％CI(-5.56,2.45),P=0.390]和[95％CI(-3.24,1.81),P=0.532].结论 PEG-rhG-CSF 和rhG-CSF疗效相当,但是在不良反应发生率上PEG-rhG-CSF明显低于rhG-CSF.
Meta-analysis of PEG-rhG-CSF and rhG-CSF in the treatment of chemotherapy-induced neutropenia
Objective Pegylated recombinant human granulocyte colony stimulating factor(PEG-rhG-CSF)and recombinant human granulocyte colony stimulating factor(rhG-CSF)are the main drugs in the treatment of chemotherapy-induced neutropenia(CIN)for malignant tumors.In order to comprehensively evaluate the differences in efficacy and adverse reactions between them,it is necessary to analyze the existing experimental studies on them to better guide the clinic.Methods Chinese and English articles published in PubMed,Embase,Web of Science and China BioMedical Literature Database from June 2005 to June 2023 were searched.Results Nine randomized controlled studies were compared.The results showed that there was no significant difference in the incidence of CIN between patients receiving PEG-rhG-CSF treatment and rhG-CSF treatment(n=695,RR=0.49,95％CI[0.24,1.02],P=0.06),suggesting that the two treatments were equivalent.There was a significant difference in the incidence of adverse reactions between the two groups(n=695,RR=0.66,95％CI[0.55,0.78],P＜0.000 01).The reliability of the two treatments was good,and there was no publication bias and heterogeneity,Egger's results were(95％CI[5.56,2.45],P=0.390)and(95％CI[3.24,1.81],P=0.532).Conclusion PEG-rhG-CSF and rhG-CSF have equivalent efficacy,but PEG-rhG-CSF is significantly lower than rhG-CSF in the incidence of adverse reactions.
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