利福喷丁与利福平治疗肺结核的Meta分析

Meta-analysis of rifapentine vs rifampicin for the treatment of pulmonary tuberculosis

目的:评价利福喷丁与利福平治疗肺结核的疗效及安全性。方法:搜集公开发表的有关利福喷丁与利福平治疗肺结核的随机对照临床试验,按照Meta分析方法,运用Rev Man4.2.10软件对符合条件的纳入文献进行分析。结果:纳入文献13篇,总样本量2294例,利福喷丁治疗组1171例,其中,痰菌转阴1118例,病灶吸收1147例,空洞闭合393例;利福平治疗组1123例,其中,痰菌转阴1044例,病灶吸收1024例,空洞闭合335例。痰菌转阴、空洞闭合的疗效指标合并OR值分别为1.67,1.48(P<0.01),病灶吸收疗效指标合并OR值为1.43(P>0.05)。结论:与利福平治疗肺结核病相比,利福喷丁在促进痰菌转阴、空洞闭合方面疗效更显著,但在促进病灶吸收方面疗效差异无统计学意义。

Objective： To assess the effectiveness and safety of rifapentine and rifampicin in the treatment of pulmonary tuberculosis. Methods： Randomized controlled trials of rifapentine and rifampicin in the treatment of pulmonary tuberculosis were collected, and the included studies were assessed by Rev Man4.2 software. Results： Thirteen RCTs studying 2294 patients were included in the meta-analysis. Among 1171 cases of the rifapentine treatment group, 1118 cases were sputum negative, 1147 cases were absorption of tuberculosis nidus, and 393 were closure of pulmonary cavity. Among 1123 cases of the rifampicin treatment group, 1044 cases were sputum negative, 1024 cases were absorption of tuberculosis nidus, and 335 cases were closure of pulmonary cavity. The pools OR values of therapeutic effects in sputum negative and closure of pulmonary cavity were at 1.67 and 1.48 respectively （P 〈 0.01）, while that of the absorption of tuberculosis nidus was at 1.43 （P 〉 0.05）. Conclusion： Rifapentine was associated with better effective rates in sputum negative and closure of pulmonary cavity than rifampicin in the treatment of pulmonary tuberculosis, however, there was no significant difference in promoting the absorption of tuberculosis nidus.