对于结核艾滋病双重感染患者不同治疗方式死亡率的Meta分析

A Meta analysis about mortality of different treatment in TB/HIV co-infected patients

目的比较不同阶段实施高效抗反转录病毒(HAART)治疗的结核、艾滋病双重感染者的死亡情况,为治疗提供进一步的证据支持。方法通过对Pubmed、Embase、Cochrane Central Register of Controlled Trials(CENTRAL)等数据库进行文献检索,查找针对结核、艾滋病双重感染患者早期进行ART治疗以及晚期进行ART治疗的临床随机对照试验。采用固定效应模型对所纳入的文献进行Meta分析,并对其发表偏倚进行评估。结果共纳入7篇临床对照试验研究的文献进行分析。患者死亡率的总体OR值为0.64(95%CI:0.50～0.82),表明早期ART治疗组的死亡率低于晚期ART治疗组(P<0.05)。结论对双重感染患者早期进行ART治疗能够明显降低其死亡率。

Objective To compare the difference of mortality between TB/HIV co-infected patients with early initiation high active antiretroviral therapy （HAART） versus and TB/HIV co-infected patients with later initiation of HAART versus. Methods A systematic search of the literature by searching electronic databases PubMed, Embase and the Cochrane Central Register of Controlled was carried out for the clinical trials about early initiation HAART versus later initiation of HAART versus in TB/HIV co-infected patients. Two reviewers selected eligible trials and extracted information, respectively. Studies were pooled using a fixed effect model, conducting additional analyses by publication bias evaluation. Results Pooling 7 trials, the overall odds ratio of mortality between early ART groups and later ART groups was 0.64 （95%CI： 0.50-0.82）. The mortality in early ART groups was significantly lower than the later ART groups （P〈0.05）. Conclusion The initiation of ART to TB/HIV co-infected patients at an early stage can reduce the risk of mortality.