两性霉素B膀胱冲洗治疗真菌性尿路感染的meta分析

Effect of bladder irrigation with amphotericin B for treatment of urinary tract fungal infection:a meta-analysis

目的评价两性霉素B膀胱冲洗治疗真菌性尿路感染患者的有效性和安全性。方法采用循证学方法,检索Cochran图书馆注册临床对照试验数据库至2017年第12期;Pub Med、EMBase、Web of Knowledge数据库、中国生物医学文献数据库、中国期刊全文数据库、万方数据库、维普中文科技期刊数据库,文献检索时间从建库至2018年3月,纳入探讨两性霉素B膀胱冲洗治疗真菌性尿路感染的研究,采用Revman5.3统计软件进行meta分析。结果共检出96篇文献,最终纳入9项研究,纳入患者853例。Meta分析结果显示,与氟康唑口服治疗相比,两性霉素B膀胱冲洗给药治疗真菌性尿路感染的有效率高[OR=1.66,95%CI(1.2,2.3),P=0.002],且发生不良反应较少。结论两性霉素B膀胱冲洗给药可以提高真菌性尿路感染的疗效,由于纳入研究样本量较小,该结论尚需高质量的临床对照研究进一步验证。

Objective To assess the efficacy and safety of bladder irrigation with amphotericin B for treatment of fungal infection in the urinary tract.Methods All the available randomized controlled trials（published before March,2018） examining bladder irrigation with amphotericin B for treatment of urinary tract fungal infection were searched in the Cochrane Central Register of Controlled Trials（Issue 12,2017）,Pub Med,EMBase,Web of Knowledge Database,CNKI,CBM,Wanfang DATA and VIP information.Data were extracted from the selected trials for meta-analysis using Rev Man 5.3 software.Results A total of 96 studies were retrieved from the databases,and 9 trials involving 853 patients were included in the analysis.Meta-analysis results showed that compared with oral administration of fluconazole,bladder irrigation with amphotericin B was more effective in the treatment of fungal infection in the urinary tract（OR=1.66,95%CI：1.2-2.3,P=0.002） and was associated with less adverse reactions.Conclusion Bladder irrigation with amphotericin B can improve the curative effect of fungal infection in the urinary tract,but due to the small sample size of the included studies,this conclusion needs to be further validated by highquality studies.