期刊文献+

他克莫司二联与三联用药对肝移植术后患者有效性和安全性的Meta分析 被引量:2

Effectiveness and Safety of Tacrolimus Dual Regimen versu Triple Regimen for Patients after Liver Transplantation:A Meta-analysis
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摘要 目的:评价肝移植术后患者以他克莫司(FK506)不同联合用药方案的有效性和安全性。方法:计算机检索PubMed、Embase、SCI、中国期刊全文数据库(CNKI)、中国生物医学文摘数据库(CBM),同时手工检索相关专业期刊,纳入与FK506相关的随机对照试验。由2名评价者独立提取资料后进行质量评价,并采用RevMan5.0软件进行分析。结果:共纳入7个研究,包括1793名肝移植术后患者,观察终点为术后3、6、12个月。结果显示,FK506二联与三联用药方案比较,除在3个月时急性排斥反应[RR=1.19,95%C(I1.02,1.38)]高于三联用药,差异具有统计学意义外,患者或移植物存活率、感染和糖尿病发生率2组间差异均无统计学意义。结论:FK506三联用药与二联用药相比可降低急性排斥反应的发生率,增加对移植肝的保护,同时不增加毒副作用。 OBJECTIVE: To evaluate the effectiveness and safety of tacrolimus (FK506) dual regimen versus triple regimen for patients after liver transplantation. METHODS: Randomized controlled trials involving FK506 were retrieved from PubMed, Embase, SCI, CNKI, CBM. We also searched relevant journals by hand. Data were extracted and the quality of literatures were evaluated by two independent reviewers and analyzed by RevMan 5.0 software. RESULTS: A total of 7 studies were included, in- volving 1 793 patients. The endpoints were 3,6, 12 months after transplantation. Meta-analysis showed that the rate of acute rejection [RR=1.19, 95%CI (1.02,1.38)] in dual regimen group was higher than triple regimen group 3 months after transplantation, there was statistical significance. Graft or patient survival rate, infection and the incidence of diabetes had no significant different between 2 groups. CONCLUSION: Compared with dual regimen of FK506, the triple regimen can reduce the acute rejection after liver transplantation, improve the protection of liver and has no additional toxic side effects.
出处 《中国药房》 CAS CSCD 2012年第10期918-922,共5页 China Pharmacy
关键词 他克莫司 肝移植 META分析 Tacrolimus Liver transplantation Meta-analysis
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参考文献13

  • 1Goto T, Kino T, Hatanaka H, et al. Discovery of FK506, a novel immunosuppressant isolated from streptomyces tsukubaensis[J].Transplant Proc, 1987,19 (5 Suppl 6) :4.
  • 2Ochiai T, Nakajima K, Nagata M, et al.Effect of a new im- munosuppressive agent, FKS06, on heterotopic cardiac allotransplantation in the rat[J]. Transplant Proc, 1987, 19 (1Pt 2): 1 284.
  • 3European FK506 Multicenter Liver Study Group. Rando- mised trial comparing tacrolimus (FKS06) and cyclospo- fin in prevention of liver allograft rejection[J]. Lancet, 1994,344(8 920):423.
  • 4The U.S.Multicenter FK506 Liver Study Group.A compar- ison of tacrolimus (FK506) and cyclosporine for immu- nosuppression in liver transplantation[J]. N Engl J Med, 1994,331(17):1 110.
  • 5Neuhaus P, Langrehr JM, Williams R, et al. Tacrolimus- based immunosuppression after liver transplantation: a randomised study comparing dual versus triple low-dose oral regimens[J]. Transpl lnt, 1997,10 (4) :253.
  • 6李静,李幼平.不断完善与发展的Cochrane系统评价[J].中国循证医学杂志,2008,8(9):742-743. 被引量:195
  • 7Boillot O, Baulieux J, Wolf P, et al. Low rejection rates with tacrolimus-based dual and triple regimens following liver transplantation[J]. Clin Transplant, 2001, 15 (3) : 159.
  • 8Gonzalez MG, Madrazo CP, Rodriguez AB, et al. An open, randomized, multicenter clinical trial of oral tacrolimus in liver allograft transplantation: a comparison of dual vs. triple drug therapy[J]. Liver Transpl, 2005,11 (5) :515.
  • 9Jain A, Kashyap R, Dodson F, et al. A prospective random- ized trial of tacrolimus and prednisone versus tacrolimus, prednisone and mycophenolate mofetil in primary adult liver transplantation: a single center report[J]. Transplan- tation,2001,72(6) : 1 091.
  • 10Pelletier S J, Vanderwall K, Debroy MA, et al. Preliminary analysis of early outcomes of a prospective, randomized trial of complete steroid avoidance in liver transplantation [J]. TransplantProc,2005,37(2):l 214.

二级参考文献23

  • 1Luciano E Mignini,Khalid S Khan,刁骧(译),李幼平(审校).动物研究系统评价的方法学质量调查[J].中国循证医学杂志,2006,6(10):751-755. 被引量:9
  • 2Zahir H, Nand RA, Brown KF. Validation of methods to study the distribution and protein binding of taerolimus in human blood [J] . Journal of Pharmacological and Toxicological Methods, 2001,46(1) : 27.
  • 3Victor W,Oelleric HM.New developments in the immunosuppressive drug monitoring ofcyclosporine, tacrolimus, and azathioprine [J ] . Clinical Biochem istry, 2001, 34(1) :9.
  • 4Ihor B,Dawna D,Qais A. Effect of low and high fat meals on Tacrolimus absorption following 5 mg single oral doses to healthy human subjects [J]. Clin Pharmacol ,2001, 41(2) : 176.
  • 5Napoli KL.Is Microparticle enzyme linked immunoassay (MEIA) reliable for use in tacrolimus TDM? Comparison of MEIA to liquid chromatography with mass spectrometric detection using longitudinal trough samples from transplant Recipients[J ] . Ther Drug Monit, 2006,28(4) : 491.
  • 6Regazzi MB, Renaldi M, Molinaro M, et al. Clinical pharmacokinetics of tacrolimus in heart transplant recipients [J ]. Ther Drug Monit, 1999, 21(1) :2.
  • 7Borrows R, Chusney G, Loucaidou M, et al. Tacrolimus monitoring in renal transplantation: a comparison between high - performance liquid chromatography and immunoassay [J] .Transplantation Proceedings, 2005, 37(4) :1 733.
  • 8Chena YL, Hirabayashi H, Akhtar S, et al. Simultaneous determination of three isomeric metabolites of tacrolimus(FK506) in human whole blood and plasma using high performance liquid chromatography - tandem mass spectrometry [J ] .Journal of Chromatography B, 2006,830(2) :330.
  • 9Paul S, Rutherford DM, Taylor PJ, et al. Evaluation of microparticle enzyme immunoassay against HPLC- Mass spectrometry for the determination of whole - blood tacrolimus in heart - and lung - transplant recipients [J] . Clinical Biochemistry ,2000,33(7):558.
  • 10Qing LZ, Simpson J. A specific method for the measurement of tacrolimus in human whole blood by liquid chromatography/tandem mass spectrometry [J ] . Ther Drug Moni, 1997, 19(4) :470.

共引文献224

同被引文献26

  • 1周永恒,石磊,唐镜波.影响他克莫司血药浓度的因素[J].中国药房,2005,16(24):1909-1911. 被引量:15
  • 2章海涛,胡伟新,谢红浪,曾彩虹,陈惠萍,刘志红,黎磊石.普乐可复与环磷酰胺诱导治疗Ⅳ型狼疮性肾炎的疗效比较[J].肾脏病与透析肾移植杂志,2006,15(6):501-507. 被引量:28
  • 3国家食品药品监督管理局药品安全监管司,国家药品不良反应中心编.药品不良反应报告和监测工作手册[S].2005:46.
  • 4Denys A,Allain F,Masy E,et al.Enhancing the effect of secreted cyclophilin B on immunosuppressive activity of cyclosporine[J].Transplantation,1998,65(8):1 076.
  • 5Shapiro R,Scantlebury V,Jordan ML,et al.Posttransp lantd iabetes in pediatric recipients on FK506 rolimus[J].Transplantation,1999,67(5):771.
  • 6Mc Diarmid S V,Anand R,Lindblad A S,et al.Studies of pediatric liver transplantation:2002 update.An overview of demographics,indications,timing,and immunosuppressive practices in pediatric liver transplantation in the United States and Canada[J].Pediatr Transplant,2004,8(3):284-294.
  • 7Busuttil R W,Klintmalm G K.肝移植[M].2版.上海:第二军医大学出版社,2009:919-945.
  • 8Imanieh M H,Erjaee A,Dehghani S M,et al.Early postoperative complications of pediatric liver transplantation[J].Indian Pediatr,2009,46(12):1088-1090.
  • 9Staatz C E,Taylor P J,Lynch S V,et al.Population pharmacokinetics of tacrolimus in children who receive cut-down of full liver transplants[J].Transplantation,2001,72(6):1056-1061.
  • 10Berengue J I,Lopez-Espinoza J A,Ortega-Lopez J,et al.Two-tothree-fold increase in blood tacrolimus(FK506)levels during diarrhea in liver-transplanted children[J].Clin Transplant,2003,17(3):249-253.

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