利奈唑胺与替考拉宁比较治疗耐甲氧西林金黄色葡萄球菌肺炎的Meta分析

Linezolid versus Teicoplanin for MRSA Pneumonia:A Meta-Analysis

目的系统评价利奈唑胺与替考拉宁比较治疗耐甲氧西林金黄色葡萄球菌肺炎的疗效和安全性。方法计算机检索CBM、CNKI、WanFangData、VIP、ScienceDirect、PubMed、Ovid、SciFinder、The Cocharane Library（2013年第3期）和EMbase数据库．收集2003年1月～2013年3月国内外公开发表的关于利奈唑胺和替考拉宁比较治疗耐甲氧西林金黄色葡萄球菌肺炎的临床疗效和安全性的随tJLx,~照试验或两组均衡可比、非随机的前瞻性研究。按Cochrane系统评价方法，南2位研究者独立筛选文献、提取资料并评价质量后，采用RevMan5．2软件进行Meta分析。结果最终纳入7个研究，包括637例患者。Meta分析结果显示，有效率[RR=1．17，95％CI（1．04．1．32），P=0．009]、痊愈率[RR=1．06，95％CI（0．94，1．19），P=0．37]、细菌清除率[RR=1．32，5％CI（1．03，1．68），P；0．03]和不良反应发生率[RR=I．24，95％CI（0．78，1．97），P=0．37]，经Begg检验和Egger检验，P值均〉0．05。结论现有证据湿示，利奈唑胺在治疗耐甲氧西林金黄色葡萄球菌患者的临床有效率和细菌清除率优于替考拉宁，在痊愈率和不良反应发生率方面，两者无明显差异。

Objective To systematically review the effectiveness and safety of linezolid versus teicoplanin in patients with MRSA pneumonia. Methods Such databases as CBM, CNKI, WanFang Data, VIP, Science Direct, PubMed, Ovid, SciFinder, The Cochrane Library （Issue 3, 2013） and EMbase were electronically searched for published articles （randomized controlled trials or non-randomized prospective trials with comparable baseline between groups） at home and abroad on the clinical effectiveness and safety of linezolid versus teicoplanin in patients with MRSA pneumonia from January 2003 to March 2013. Using the Cochrane methods, two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software in clinical cure rates, clinical effective rates, microbiologic eradication rates, and adverse reaction incidences. Results Finally, 7 studies were included involving 637 patients. The results of meta-analysis were clinical effective rates （RR=I.17, 95%CI 1.04 to 1.32, P=0.009）, clinical cure rates （RR=I.06, 95%CI 0.94 to 1.19, P=0.37）, bacterial clearance rates （RR=l.32, 95%CI 1.03 to 1.68, P=0.03）, and adverse events rates （RR=l.24, 95%CI 0.78 to 1.97, P=0.37）. The results of Begg test and Egger test were not significant （P〉0.05）. Conclusion Current evidence shows that, in treating MRSA pneumonia, linezolid is better than teicoplanin in clinical effective rates and bacterial clearance rates. However, they are alike in clinical cure rates and bacterial clearance rates.