聚桂醇与平阳霉素对血管瘤及静脉畸形疗效及安全性的Meta分析

Efficacy and security of lauromacrogol and pingyangmycin in treatment of hemangioma and venous malformation: A meta-analysis

目的系统评价平阳霉素与聚桂醇治疗血管瘤及静脉畸形的疗效和安全性。方法检索PubMed、CochraneLibrary、Embase、WebofScience、中国期刊全文数据库(CNKI)、万方数据库、维普数据库及CBM数据库,查找平阳霉素与聚桂醇治疗血管瘤及静脉畸形的临床随机对照试验研究,检索时限为建库至2018年11月30日。由2位研究者根据纳入及排除标准筛选文献、提取资料并评价纳入研究的偏倚风险,采用RevMan 5.3软件进行Meta分析。结果最终纳入12个研究,包括1619例患者。Meta分析结果显示,聚桂醇治疗血管瘤及静脉畸形的治愈率高于平阳霉素,差异有统计学意义(OR=1.98,95%CI 1.58~2.49,P<0.001),但二者的治疗有效率及无效率差异无统计学意义(OR=1.17,95%CI 0.40~3.41,P=0.77;OR=0.44,95%CI 0.12~1.66,P=0.23)。聚桂醇组的并发症发生率明显低于平阳霉素组,差异有统计学意义(OR=0.27,95%CI 0.17~0.44,P<0.001)。结论在血管瘤及静脉畸形的治疗中,聚桂醇的治愈效果及安全性明显优于平阳霉素,但对于有效缩小病灶,二者无明显差异。

Objective To systematically evaluate the clinical efficacy and safety of pingyangmycin and lauromacrogol in treatment of hemangioma or venous malformation. Methods All the databases of PubMed, Cochrane Library, Embase, Web of Science, Wanfang, CBM, VIP and CNKI were searched from their inception to November 30, 2018 to seek the randomly controlled trials (RCTs) involving the efficacy and adverse reaction of lauromacrogol and pingyangmycin in treatment of hemangioma and venous malformation. According to the inclusion and exclusion criteria, two reviewers were respectively responsible for screening researches, extracting data and assessing the risk of bias of included studies. Subsequently, meta-analysis was performed with RevMan 5.3 software. Results A total of 12 studies containing 1619 individuals with hemangioma or venous malformation were incorporated. Meta analysis showed that the cured rates of hemangioma and venous malformation were superior when treated with lauromacrogol than with pingyangmycin, the difference was statistically significant (OR=1.98, 95%CI 1.58-2.49, P<0.001). While no significant difference existed in the efficiency (OR=1.17, 95%CI 0.40-3.41, P=0.77) and inefficiency (OR=0.44, 95%CI 0.12-1.66, P=0.23) when treating hemangioma and venous malformation with lauromacrogol or pingyangmycin. The incidence of complication was distinctly lower in lauromacrogol group than in pingyangmycin group with statistical significance (OR=0.27, 95%CI 0.17- 0.44, P<0.001). Conclusion In the treatment of hemangioma and venous malformation, lauromacrogol is obviously superior to pingyangmycin in the therapeutic effect and safety, but there is no significant difference in effectively reducing the focus.