莫西沙星治疗难治复治多耐药肺结核的系统评价

Moxifloxacin for Refractory,Recurrent,Multi-Drug Resistant Pulmonary Tuberculosis:A Systematic Review

目的系统评价莫西沙星联合抗结核药物治疗复治肺结核的疗效与安全性。方法检索Medline(1950—2009)、外文全文生物医学期刊(FJIS,1995—2008)、中国医院数字图书馆(CNKI,1994—2008)、中国生物医学文献数据库(CBMdisc,1977—2008)、WHO EML等数据库和网站中所有莫西沙星治疗难治复治多耐药肺结核随机对照临床试验,按照《药品文献评价指导原则》同时采用Cochrane协作网提供的RevMan4.2.10软件分析数据。结果最终纳入7个RCT。Meta分析结果显示,莫西沙星治疗组与对照组相比,痰菌转阴率[RR=1.11,95%CI(1.03,1.19)],临床有效率[RR=1.14,95%CI(1.04,1.25)]的差异均有统计学意义。结论现有证据表明,莫西沙星用于难治、复治、多耐药肺结核治疗,有助于痰菌转阴。

OBJECTIVE To assess the effectiveness and security of moxifloxacin for refractory, recurrent, multi-drug resistant pulmonary tuberculosis. METHODS To search he Medline（1950-2009）, FJIS（1995-2008）, CNKI（1994-2008）, CBMdisc（1977-2008） , WHO EML to collect randomized controlled trails （RCTs） which moxifloxacin was uesd for refractory, recurrent, multi-drug resistant pulmonary tuberculosis. RESULTS The data included 7 RCTs was analyzed by using the Cochrane Collaboration’s RevMan 4.2.10 software. Compared with control group, moxifloxacin was more effective in sputum negative conversion rate [RR=1.11, 95%CI（1.03, 1.19）] and clinical efficacy rate[RR=1.14, 95%CI（1.04, 1.25）]. CONCLUSION Moxifloxacin is useful for sputum negative conversion in patients with refractory, recurrent, multi-drug resistant pulmonary tuberculosis.