含左氧氟沙星化疗方案治疗肺结核的系统评价

Clinical Efficacy of Combination Regimens with Levofloxacin for Pulmonary Tuberculosis:A Systematic Review

目的:系统评价含左氧氟沙星方案治疗肺结核的临床疗效。方法:检索PubMed、外文全文生物医学期刊(FJIS)、中国生物医学文献数据库(CBMdisc)、中国医院数字图书馆(CNKI)、WHOICTRP、WHO EML等数据库和网站中自建库至2010年10月所有含有左氧氟沙星方案治疗肺结核的随机对照临床试验(RCT),采用Cochrane协作网提供的RevMan 4.2软件分析数据。结果:最终纳入18个RCT,Meta分析结果显示,含左氧氟沙星方案治疗组与对照组相比,痰转阴情况[RR=2.76,95%CI(1.99,3.84)]、病灶吸收情况[RR=4.59,95%CI(3.53,5.96)]的差异均有统计学意义。结论:现有证据表明,含左氧氟沙星方案治疗肺结核,有助于提高痰菌转阴率和病灶吸收率。受本评价纳入研究质量所限,尚需开展更多高质量的研究进一步分析。

OBJECTIVE： To systematically assess the clinical efficacy of combination regimens with levofloxacin for pulmonary tuberculosis.METHODS： We searched the databases including PubMed,FJIS,CNKI,CBMdis,WHOICTRP,WHO EML to collect randomized controlled trails（RCTs） on the combination regimens with levofloxacin for pulmonary tuberculosis which were published from the time when those databases were established until October 2010.The data was analyzed by using the Cochrane Collaboration＇s RevMan 4.2 software.RESULTS： 18 RCTs were included.Compared with control group,levofloxacin-contained group was more effective in rate of sputum negative[RR=2.76,95%CI（1.99,3.84）] and rate of focus absorption [RR=4.59,95%CI（3.53,5.96）],all showing significant differences between the two groups.CONCLUSION： The available evidences revealed the combination regimens with levofloxacin resulted in higher sputum negative rate and higher focus absorption rate in patients with pulmonary tuberculosis.However,in the light of the low quality of RCTs included in this systematic review,further analysis on more RCTs of high quality remains to be done.