摘要
目的通过Meta分析系统评价核苷(酸)类似物治疗HBV相关慢性肝功能衰竭的疗效。方法检索1990年至2010年在Medline、PubMed、中国知网(CNKI)全文数据库、万方数据库、中国生物医学文献数据库等公开发表的中、英文文献,并辅以文献追述和手工检索的方法,对相关的参考文献严格按照文献纳入、排除标准来筛选,采用RevMan5.0版统计软件进行Meta分析,应用森林图、漏斗图、失安全系数对判定指标进行敏感性分析和发表偏倚分析。结果20篇中、英文文献,共计1240例病例纳入研究,HBVDNA转阴率的相对危险度(RR)为3.37,95%可信区间(CI)为2.20-5.16(Z-5.60,P〈0.01);PTA加权均数差(wMD)为34.70,95%CI为25.62-43.79(Z-7.49,P〈0.01);AlbWMD为4.73,95%CJ为2.95-6.51(Z-5.21,P〈0.01);ALTWMD为-42.58,95%CI为-59.74--25.41(Z-4.86,P〈0.01);TBilWMD为-150.95,95%CI为-199.29--102.62(Z-6.12,P〈0.01);病死率RR为0.55,95%CI为0.48-0.64(Z-8.09,P〈0.01)。结论核苷(酸)类似物能明显提高HBV相关慢性肝功能衰竭患者HBVDNA转阴率,改善PTA、Alb水平,降低ALT、TBil水平,从而降低HBV相关慢性肝功能衰竭患者的近期病死率。
[Abstract] Objective To evaluate the efficacy of nucleos (t)ide analogues in patients with hepatitis B virus (HBV)-related chronic liver failure through Meta-analysis. Methods Literature search was done in Medline, PubMed, China National Knowledge Infrastracture (CNKI), Wanfang Database and China Biology Medicine (CBM) for papers published from 1990 to 2010 in Chinese orEnglish, as well as the references in the relevant literature complemented by retrospective and manual literature search. Only literatures fully matching the inclusion and exclusion criteria could be included in this study. RavMan 5.0 statistical software was utilized for Meta-analysis. Then the sensitivity and publication bias about the data were measured by forest plot, funnel plot and fail-safe number. Results Total 1240 patients from 20 controlled clinical trials reported in Chinese and English papers were included in this study. The indicators of therapeutic efficacy were as below: HBV DNA undetectable rate relative risk (RR) =3. 37, 95%CI: 2. 20, 5. 16 (Z=5. 60, P〈0. 01), prothrombin activity (PTA) weighted mean difference (WMD) = 34.70, 95%CI: 25.62, 43.79 (Z= 7.49, P〈0.01), albumin (Alb) WMD=4.73, 95% CI: 2.95, 6.51 (Z= 5.21, P〈0. 01), alanine aminotransferase (ALT) WMD=--42.58, 95%CI: --59.74,--25.41 (Z=4.86, P〈0. 01), total bilirubin (TBil)WMD=--150.95, 95%CI:--199.29,--102.62 (Z=6. 12, P〈0.01), mortality RR=0. 55, 95% CI:0. 48, 0. 64 (Z=8. 09, P%0. 01). Conclusion Nucleos(t) ide analogues treatment could significantly increase HBV DNA undetectable rate, improve PTA and Alb, decrease levels of ALT and TBil, which further reduces the short-term mortality of the patients with HBV-related chronic liver failure.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2012年第2期105-112,共8页
Chinese Journal of Infectious Diseases
基金
河北省卫生厅医学适用跟踪项目(GL200805)