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持续泵入对比间断滴注两性霉素B治疗侵袭性真菌感染疗效与安全性的Meta分析
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| 篇名： | 持续泵入对比间断滴注两性霉素B治疗侵袭性真菌感染疗效与安全性的Meta分析 |
| TITLE： | Efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection：a meta-analysis |
| 摘要： | 目的 比较持续泵入与间断滴注两性霉素B治疗侵袭性真菌感染的疗效与安全性，为临床治疗提供循证参考。方法计算机检索PubMed、theCochraneLibrary、WebofScience、Embase、万方、中国知网、中国生物医学文献数据库、维普网，收集24h持续泵入（试验组）对比间断滴注（对照组）两性霉素B的随机对照试验（RCT）及队列研究，检索时间均从建库起至2023年1月。筛选文献、提取资料后采用改良的Jadad量表评价RCT的质量，采用纽卡斯尔-渥太华评分量表评价队列研究的质量；采用RevMan5.4软件进行Meta分析、敏感性分析。结果共纳入7篇文献，包括1篇RCT及6篇队列研究，共计767例患者。Meta分析结果显示，试验组患者的临床有效率[RR＝1.44，95%CI（1.13，1.83），P＝0.003]显著高于对照组，全因死亡率[RR＝0.37，95%CI（0.19，0.72），P＝0.003]、输液反应发生率[RR＝0.28，95%CI（0.18，0.43），P＜0.00001]均显著低于对照组；两组患者的肾功能损害发生率比较，差异无统计学意义[RR＝0.71，95%CI（0.45，1.11），P＝0.13]。敏感性分析结果显示，本研究所得结果稳健。结论24h持续泵入两性霉素B治疗侵袭性真菌感染的疗效和安全性均优于间断滴注。 |
| ABSTRACT： | OBJECTIVE To compare efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection， and to provide evidence-based reference for clinical treatment. METHODS Retrieved from PubMed， the Cochrane Library， Web of Science， Embase， Wanfang， CNKI， CBM and VIP database， randomized controlled trial （RCT） and cohort study about 24 h continuous pump （trial group） versus intermittent infusion （control group） of amphotericin B were collected from the inception to Jan. 2023. After literature screening and data extraction， the quality of RCT was evaluated with modified Jadad scale， and the quality of cohort study was evaluated with Newcastle-Ottawa scale. Meta-analysis and sensitivity analysis were performed by using RevMan 5.4 software. RESULTS A total of 7 literature were included， involving 1 RCT and 6 cohort studies with a total of 767 patients. The results of meta-analysis showed that the clinical effective rate [RR＝1.44， 95%CI （1.13，1.83）， P＝0.003] of trial group was significantly higher than that of control group， and all-cause mortality rate [RR＝0.37， 95%CI（0.19，0.72），P＝0.003] and the incidence rate of infusion reaction [RR＝0.28，95%CI（0.18，0.43）， P＜0.000 01] were significantly lower than control group； there was no statistical significance in the incidence rate of renal impairment between 2 groups [RR＝0.71，95%CI（0.45，1.11），P＝0.13] . The sensitivity analysis results showed that the results obtained in this study were robust. CONCLUSIONS The efficacy and safety of 24 h continuous pump of amphotericin B are better than those of intermittent infusion in the treatment of invasive fungal infection. |
| 期刊： | 2023年第34卷第09期 |
| 作者： | 罗梦林；许汝福；胡雪莲；张蓉 |
| AUTHORS： | LUO Menglin，XU Rufu，HU Xuelian，ZHANG Rong |
| 关键字： | 侵袭性真菌感染；两性霉素B；持续泵入；间断滴注；疗效；安全性；Meta分析 |
| KEYWORDS： | invasive fungal infection； amphotericin B； continuous pump； intermittent infusion； efficacy； safety； meta-analysis |
| 阅读数： | 156 次 |
| 本月下载数： | 7 次 |
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