炎症性肠病患者术前应用英夫利昔与术后发生感染性并发症风险的Meta分析

Pre-operative Use of Infliximab and the Risk of Post-operative Infectious Complications in Patients with Inflammatory Bowel Disease: Meta-analysis

目的系统评价炎症性肠病患者术前应用英夫利昔(IFX)是否提高术后发生感染性并发症的风险。方法计算机检索Pub Med、Web of Science、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,检索时间均为1990年1月-2013年4月,搜集研究炎症性肠病患者术前应用IFX是否提高术后发生感染性并发症的风险的研究,由2位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后,结果应用Rev Man 5.1软件进行Meta分析。结果最终纳入14项队列研究。Meta分析结果显示:溃疡性结肠炎患者中IFX组和对照组术后发生感染性并发症风险差异无统计学意义[RR=0.99,95%CI(0.47,2.07),P=0.97],克罗恩病患者中IFX组和对照组术后发生感染性并发症风险差异无统计学意义[RR=1.32,95%CI(0.87,1.98),P=0.19]。结论有限数据的Meta分析结果显示,术前应用IFX并不增加术后感染性并发症的风险。

Objective To assess whether pre-operative use of infliximab （IFX） will increase the risk of post- operative infectious complications in patients with inflammatory bowel disease （IBD）. Methods Pubmed, Web of Science, CBM, CNKI and Wanfang database were searched for all the trials that investigated the effects of infliximab on postoperative infectious complication rates in patients with IBD between January 1990 and April 2013. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted data and assessed the quality of the included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results Totally, 14 cohort studies were finally included in the review. There was no significant difference on infectious complications [RR=0.99, 95%CI （0.47, 2.07）, P=0.97] between IFX groups and control groups with ulcerative colitis. The same results were found in patients with Crohn＇s disease on infectious complications [RR=l.32, 95%CI （0.87, 1.98）, P=0.19]. Conclusion Pre-operative infliximab use is safe and does not increase the risk of post-operative infectious complications in patients with IBD.