国内静脉注射伏立康唑和氟康唑预防真菌感染临床疗效和安全性比较的Meta分析

Clinical efficacy and safety of intravenous injection voriconazole and fluconazole in preventing fungal infection in China: A meta analysis

目的 通过Meta分析探讨静脉注射伏立康唑和静脉注射氟康唑预防真菌感染的临床疗效和安全性。方法 以伏立康唑为实验组,氟康唑为对照组。通过计算机检索中国期刊全文数据库(CNKI)、万方数据库、维普数据库,并进一步对纳入文献的参考文献进行扩大检索。对符合纳入标准的随机对照研究(RCT)按Cochrane系统评价的方法,独立进行资料提取、质量评价并交叉核对后,采用Stata14.0软件进行Meta分析。结果 共纳入19篇研究,共计1492例患者。伏立康唑有着更高的有效率和有更低的不良反应,两者差异有统计学意义(RR=1.20,95%CI=1.14~1.26,P<0.001)和RR=0.76,95%CI=0.65~0.90,P=0.001)。同时在控制感染发热和真菌清除方面,伏立康唑有着更好的效果,两者差异有统计学意义,分别为(RR=1.63,95%CI=1.40~1.90,P<0.001和RR=1.27,95%CI=1.13~1.44,P<0.001)。结论 Meta分析结果表明伏立康唑比氟康唑预防真菌感染有更好的疗效和预后及更低的不良反应。

Objective To analyse the clinical efficacy and safety of intravenous injection voricanazole and intravenous injection fluconazole in preventing fungal infection by meta analysis. Method Voricanazole group was the experimental group and fluconazole group was the control group. The randomized controlled trials (RCTs) were retrieved from China National Knowledge Infrastructure (CNKI)、WanFang and VIP Database and references listed in all studies. RCTs meeting inclusive studies were included. The data was extracted, the quality was evaluated and cross-checked by two reviews independently according to Cochrane Handbook for Systematic Reviews of Interventions. Then Meta-analysis were conducted using Stata 14.0 software. Results A total of 19 studies and 1492 patients were included. Voriconazole had a better effect and lower adverse events, the difference was statistically significant.(RR=1.20,95%CI=1.14-1.26, P <0.001 AND RR=0.76,95%CI=0.65-0.90, P =0.001,respectively.) Voriconazole also had statistically better effects on the control of infection fever and the clearance of fungi (RR=1.63,95%CI=1.40-1.90, P <0.001 AND RR=1.27,95%CI=1.13-1.44, P <0.001,respectively). Conclusion Meta analysis showed that voriconazole had better effect and prognosis and lower adverse events in preventing fungal infection than fluconazole.