重组人粒细胞巨噬细胞集落刺激因子治疗烧伤创面疗效和安全性的系统评价

Systematic Review of Efficacy and Safety of Recombinant Human Granulocyte Macrophage Colony-Stimulating Factor in the Treatment of Burn Wounds

目的:基于荟萃分析(Meta分析)方法,系统评价重组人粒细胞巨噬细胞集落刺激因子(recombinant human granulocyte-macrophage colony stimulating factor,rhGM-CSF)治疗烧伤创面的疗效和安全性,为临床提供相关循证医学依据。方法:计算机检索中国知网、中国生物医学文献数据库、维普中文科技期刊全文数据库、万方数据库、PubMed和Cochrane图书馆等数据库,收集采用rhGM-CSF治疗烧伤创面(研究组)与常规处理烧伤创面(对照组)相比较的随机对照试验,对纳入研究的方法学质量进行评价并提取资料,采用RevMan 5.3软件进行Meta分析。结果:纳入文献8篇,共1101例患者(研究组551例,对照组550例)。Meta分析结果显示:两组患者6~7 d创面愈合率(MD=10.32,95%CI=6.72~13.92,P<0.00001),12~14 d创面愈合率(MD=18.55,95%CI=15.50~21.60,P<0.00001)、21 d创面愈合率(MD=18.96,95%CI=18.00~19.92,P<0.00001)、创面愈合时间(MD=-5.57,95%CI=-6.35^-4.78,P<0.00001)和创面愈合总有效率(RR=1.11,95%CI=1.05~1.17,P=0.0001)比较,差异均有统计学意义,研究组患者创面愈合情况明显优于对照组。两组患者创面愈合不良反应的差异无统计学意义(RR=0.99,95%CI=0.98~1.01,P=0.31)。结论:rhGM-CSF对烧伤创面的疗效明显,且无严重不良反应,但该结论需要更多高质量、大样本研究来证实。

OBJECTIVE:To systematically evaluate the efficacy and safety of recombinant human granulocytemacrophage colony stimulating factor(rhGM-CSF)in the treatment of burn wounds based on Meta-analysis,so as to provide relevant evidence-based medicine for clinical medication.METHODS:CNKI,CBM,VIP,Wanfang database,PubMed and the Cochrane Library were retrieved to collect randomized controlled trial of rhGM-CSF in the treatment of burn wounds(research group)and routine treatment of burn wounds(control group).After the methodological quality of the included studies was evaluated and the data were extracted,Meta-analysis was performed by using RevMan 5.3 software.RESULTS:Totally 8 literature were collected,including 1101 patients(with 551 cases in the research group and 550 cases in the control group).Meta-analysis results showed that the differences of wound healing rate at 6 to 7 d(MD=10.32,95%CI=6.72-13.92,P<0.00001),the wound healing rate at 12 to 14 d(MD=18.55,95%CI=15.50-21.60,P<0.00001),the wound healing rate at 21 d(MD=18.96,95%CI=18.00-19.92,P<0.00001),the wound healing time(MD=-5.57,95%CI=-6.35--4.78,P<0.00001)and the total effective rate(RR=1.11,95%CI=1.05-1.17,P=0.0001)in two groups were statistically significant,and the wound healing of the research group was significantly better than that of the control group.There was no statistically significant difference in the adverse drug reactions of wound healing between two groups(RR=0.99,95%CI=0.98-1.01,P=0.31).CONCLUSIONS:rhGM-CSF has significant efficacy on burn wounds without severe adverse drug reactions,yet this conclusion needs to be confirmed by more high-quality and large sample studies.