利奈唑胺治疗耐多药结核病的疗效与安全性的Meta分析

Meta-analysis of Therapeutic Efficacy and Safety of Linezolid in the Treatment of Multidrug-resistant Tuberculosis

目的:系统评价利奈唑胺治疗耐多药结核病(MDR-TB)的疗效与安全性。方法:计算机检索Cochrane Library、PubMed、EMbase、中国生物医学文献数据库、中国期刊全文数据库和万方数据库中关于利奈唑胺治疗MDR-TB的疗效与安全性的研究,提取资料后采用Meta-Analyst Beta 3.13统计软件进行Meta分析。结果:共纳入11项研究,合计314例患者。Meta分析结果表明,利奈唑胺治疗MDR-TB的成功率为76.3%[95%CI(67.8,83.1)],失败率为15.9%[95%CI(9.3,25.8)],死亡率为14.2%[95%CI(7.2,26.0)],丢失率为6.2%[95%CI(1.8,19.4)];不良反应中的贫血、末梢神经毒性和视神经毒性发生率分别为22.8%[95%CI(11.1,41.2)]、33.5%[95%CI(23.0,46.0)]和10.4%[95%CI(5.5,18.9)]。结论:利奈唑胺治疗MDR-TB的疗效与安全性均较好,但其最佳治疗方案、不同使用剂量的有效性和安全性还需开展更多的随机对照试验进一步明确。

OBJECTIVE： To review the efficacy and safety of linezolid in the treatment of multidrug-resistant tuberculosis （MDR-TB） systematically. METHODS： Retrieved from Cochrane Library, PubMed, EMbase, CBM, CNKI, Wanfang database, the studied about the efficacy and safety of linezolid in the treatment of MDR-TB were extracted. Meta-analysis was performed by using Meta-Analyst Beta 3.13 software. RESULTS： 11 studies were included, involving 314 patients. Results of Meta-analysis showed that in the treatment of MDR-TB by applying linezolid, combined success rate was 76.3% [95%CI （67.8,83.1.0）]; failure rate was 15.9%[95%CI（9.3,25.8）], and mortality rate was 14.2%[95%CI（7.2,26.0）]; losing rate was 6.2%[95%CI（14.5,23.7）]; the incidence of ADR, such as anemia, peripheral neurotoxicity and optic nerve toxicity were 22.8 % [95 % CI （ 11.1,41.2） ], 33.5 % [95 % CI （23.0,46.0） ] and 10.4 % [95 % CI （5.5, 18.9） ], separately. CONCLUSIONS： Linezolid shows acceptable efficacy and safety in the management of MDR-TB. However, more RCTs are needed to define the efficacy and safety of best treatment options and different doses.