核苷类药物联合免疫抑制剂治疗中国乙型肝炎病毒相关性肾小球肾炎患者疗效的Meta分析

Effect of Nucleoside Analogues Combined with Immunosuppressants on Hepatitis B Virus-Associated Glomerulonephritis in Chinese People:A Meta-Analysis

目的探讨核苷类药物联合免疫抑制剂应用于中国乙型肝炎病毒相关性肾小球肾炎(hepatitis B virus associated glomerulone nephritis,HBV-GN)患者的疗效情况。方法计算机检索PubMed、The Cochrance Central Rigster of Controlled Trials、OVID、Embase英文数据库以及中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库(WanFang Data)、中国科技期刊数据库(VIP)中有关于核苷类药物联合免疫抑制剂治疗中国HBV-GN患者疗效的随机对照试验,筛选和提取资料后进行偏倚风险评价,采用Revman5.3软件进行Meta分析。结果纳入11篇随机对照试验,中国HBV-GN患者共643例,包括试验组331例,对照组312例。Meta分析结果显示试验组的有效率、24 h尿蛋白定量、血浆白蛋白、谷丙转氨酶、谷草转氨酶改善情况优于对照组(P<0.00001或P<0.05),血肌酐2组对比差异无统计学意义(P>0.05)。结论核苷类药物联合免疫抑制剂治疗中国HBV-GN患者有一定的积极意义。

Objective To investigate the effect of nucleoside analogues combined with immunodepressants on hepatitis B virus-associated glomerulonephritis(HBV-GN)in Chinese people.Methods PubMed,Cochrance Central Rigster of Controlled Trials,OVID,Embase,CNKI,CBM,WanFang and VIP were searched for randomized controlled trials(RCTs)of the effect of nucleoside analogues combined with immunodepressants on HBV-GN in Chinese people.The risk of bias was assessed after data were selected and extracted.RevMan 5.3 software was used for meta-analysis.Results A total of 11 RCTs were identified,including 331 patients in experimental group and 312 patients in control group.Meta-analysis showed that the curative efficacy,24-hour urine protein excretion and levels of plasma albumin,glutamate transaminase and glutamate transaminase in experimental group were improved compared with control group(P<0.00001 or P<0.05).There was no significant difference in serum creatinine level between the two groups(P>0.05).Conclusion The combined treatment with nucleoside analogues and immunodepressants has a positive effect on HBV-GN in Chinese patients.