摘要
目的了解核苷类似物抗病毒治疗对乙型肝炎肝硬化患者预后的影响。方法检索PubMed、EMBASE、theCochraneCentralRegisterofControlledTrials、中国期刊全文数据库、中国科技期刊数据库（维普）、万方数据化期刊全文数据库、中国生物医学文献数据库1998年1月至2012年3月公开发表的有关乙型肝炎肝硬化患者抗病毒治疗的临床研究，共有7篇文献入选本研究，其中有l项高质量随机对照试验研究，4项队列研究，2项病例对照研究。应用Statall．0版软件对入选的研究进行Meta分析。结果Meta分析显示：（1）肝癌的发生率抗病毒治疗组为6．％（75／1116），对照组为11．2％（76／680），抗病毒治疗组肝癌的发生率明显低于对照组，OR=0．56，95％CI：0．40～0．79，P=0．001；（2）随访结束时的病死率抗病毒治疗组为10．8％（43／398），显著低于对照组的23．6％（78／331），抗病毒治疗随访结束时的病死率显著低于对照组，OR=0．36，95％CI：0．23～0．55，P=0．000。结论核苷类似物抗病毒治疗能显著降低乙型肝炎肝硬化患者肝癌的发生率和病死率。
Objective To conduct a meta-analysis to study the effect of antiviral therapy on the prognosis of patients with chronic hepatitis B （CHB）-related cirrhosis. Methods PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese Biomedical Database, Chinese Journals Full-text Database, and Wan Fang Digital Journal Full-text Database were searched for studies on nucleoside analogues antiviral treatment outcome of patients with CHB-related cirrhosis （vs. controls without antiviral therapy） published between January 1998 and March 2012. Data extraction and quality assessment was performed by two independent investigators. Heterogeneity was assessed by the I2 index. In the case of homogeneity the random-effects model was applied, and in the ease of heterogeneity the fixed-effects model was applied. The odds ratios （ORs） with 95% confidence intervals （CIs） were calculated. Results Seven studies were included in the meta-analysis： one high-quality radomized-controlled trial （RCT） study, four prospective cohort studies, and two case-control studies. Compared to the control group, the group treated with antiviral therapy showed a significantly lower incidence of hepatocellular carcinoma （11.2%, 76/680 vs. 6.7%, 75/1116; OR = 0.56, 95% C1： 0.40-0.79, P = 0.001） and lower mortality （23.6%, 78/331 vs. 10.8%, 43/398; OR = 0.36, 95% C1： 0.23 - 0.55, P = 0.000）. Conclusion Antiviral therapy with nucleoside analogues significantly reduces the incidence of hepatocellular carcinoma and mortality in patients with CHB-related cirrhosis.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2013年第6期438-441,共4页
Chinese Journal of Hepatology
关键词
肝硬化
肝炎
乙型
慢性
治疗学
癌
肝细胞
预后
核苷类似物
Liver Cirrhosis
Hepatitis B, chronic
Therapy
Carcinoma, hepatocellular
Prognosis
Nucleoside analogues
