左氧氟沙星和加替沙星治疗细菌感染的Meta分析

Meta-analysis of Levofloxacin and Gatifloxacin on Bacterial Infection

目的采用Meta分析方法评价左氧氟沙星和加替沙星治疗细菌感染的疗效和安全性。方法计算机检索＂万方数据库＂＂CNKI＂和＂维普＂数据库,纳入关于左氧氟沙星和加替沙星治疗细菌感染的随机对照试验,进行Meta分析。采用Jadad评分评价研究质量,采用χ^2检验进行异质性检验,采用固定效应模型（Mantel-Haenszel）或随机效应模型（Der Simonian-Laird）进行汇总分析。结果共有8篇文献纳入本研究。Jadad评分2~4分,1项研究2分,3项研究3分,4项研究4分。Meta分析结果显示,左氧氟沙星和加替沙星治疗细菌感染的临床总有效率（Z=1.72,P=0.09,OR=1.59,95%CI 0.94~2.71）、细菌清除率（Z=0.38,P=0.70,OR=1.10,95%CI 0.67~1.80）和不良反应发生率（Z=0.90,P=0.37,OR=1.19,95%CI 0.82~1.73）比较差异均无统计学意义。倒漏斗图显示左右不对称,提示可能存在发表性偏倚。结论左氧氟沙星和加替沙星治疗细菌感染的疗效和安全性基本相当。

Objective To evaluate the efficacy and safety of levofloxacin and gatifloxacin on bacterial infection by Meta-analysis. Methods The randomized controlled trials（ RCTs） about levofloxacin and gatifloxacin on bacterial infection were searched in Wanfang,CNKI and VIP database. Quality ratings were made according to the Jadad score,and heterogeneity test was analyzed by χ~2 test. Pooled analysis were made by Mantel-Haenszel or Der Simonian-Laird. Results A total of 8 RCTs were included in this study. 1 RCT gave 2 points,3 RCTs 3 points,4 RCTs 4 points. Meta-analysis showed there no statistically significant differences in total effective rate（ Z = 1. 72,P = 0. 09,OR = 1. 59,95% CI 0. 94-2. 71）,bacterial clearance rate（ Z =0. 38,P = 0. 70,OR = 1. 10,95% CI 0. 67-1. 80） and adverse reaction rate（ Z = 0. 90,P = 0. 37,OR =1. 19,95% CI 0. 82-1. 73）. Funnel plot showed asymmetry,suggesting there may be publication bias.Conclusion The available data indicates that the efficacy and safety of levofloxacin and gatifloxacin are approximately the same on bacterial infection.