联合利妥昔单抗治疗血小板减少症疗效的Meta分析

Meta-analysis of Efficacy on Combined Rituximab Therapy in Thrombocytopenia

目的系统评价联合利妥昔单抗治疗对血小板减少症的疗效。方法以中文“利妥昔单抗、美罗华、血小板减少症、系统评价、随机对照试验”；英文“rituximab，thrombocytopenia，systematicreview，randomizedcontrolledtrial”为检索词，进行计算机检索，筛选联合利妥昔单抗治疗与单纯治疗血小板减少症疗效比较的随机对照试验（RCT）和半RCT。检索范围为PubMed，CochraneLibrary，CNKI，CBM，VIP数据库，检索时间从各数据库建库截至2012年11月。纳入联合利妥昔单抗治疗血小板减少症的随机RCT和半RCT。纳入文献经2位研究者按照纳入标准独立筛选文献，提取资料和评价质量后，采取RevMan5．0软件进行Meta分析。结果共纳入7个研究，共计410例患者。Meta分析结果显示，联合利妥昔单抗治疗组的总缓解率高于单纯治疗组EOR=2．79，95％CI（1．80-4．31），P〈0．00001]，经异质性检验显示7个试验存在异质性（χ2=15．26，P-0．02）。结论联合利妥昔单抗治疗对血小板减少症有一定疗效，有必要开展更多设计良好的临床随机对照试验，进一步证明其临床效果。

Objective To evaluate the curative efficacy of rituximab combined treatment in patients with thrombocytopenia. Method Randomized controlled trials and quasi-randomized controlled trials of combined rituximab in the treatment of thrombocytopenia were collected, through retrieving PubMed, Cochrane Library, CNKI, CBM, VIP database on line, from database building to November 2012. Two researchers screened, extracted materials and evaluated literature quality according the inclusion criteria independently. The literature data were taken RevManS. 0 software to do Meta analysis. Results Seven trials involving 410 patients were retrieved. Meta-analysis results suggested that the overall response rate of rituximab combined treatment group was higher than simplex therapy group [OR = 2.79, 95% CI（1.80-4.31）, P〈0. 00001]. Heterogeneity analysis showed there was heterogeneity among 7 trials （χ2=15.26, P= 0.02）. Conclusions Based on the present review results, rituximab combined treatments in thrombocytopenia have a certain effect, it is necessary to carry out more well-designed randomized controlled trials, and further evidence of its clinical effect.