摘要
目的对泼尼松联合硫唑嘌呤(PRED+AZA)治疗自身免疫性肝炎(autoimmune hepatitis,AIH)进行Meta分析,以评估标准治疗的疗效及安全性。方法检索PubMed、EmBase、Cochrane图书馆、CNKI、CBM、万方及维普数据库中关于PRED+AZA治疗AIH的随机对照试验。对纳入的文献进行质量评价。提取文献中AIH患者治疗后的完全缓解率、生化缓解率、不良反应发生率和死亡率,采用RevMan 5.3软件进行统计学分析。结果共纳入11篇文献,其中英文文献7篇,中文文献4篇。Meta分析显示:对照组治疗AIH的完全缓解率比PRED+AZA组高(RR=0.79,95%CI:0.67~0.94,Z=2.69,P<0.05)。亚组分析显示,单用PRED治疗AIH的完全缓解率与PRED+AZA比较,差异无统计学意义(RR=0.81,95%CI:0.54~1.23,Z=0.97,P>0.05),Bude+AZA治疗AIH的完全缓解率比PRED+AZA高(RR=0.77,95%CI:0.63~0.93,Z=2.71,P<0.05);与对照组相比,PRED+AZA治疗AIH的生化缓解率和不良反应发生率较高,死亡率较低,但差异均无统计学意义(P>0.05)。结论替代治疗AIH的完全缓解疗效优于PRED+AZA,但生化缓解、不良反应发生和死亡情况无明显差异。单用PRED治疗AIH的完全缓解疗效与PRED+AZA相当,而Bude+AZA治疗AIH的完全缓解疗效优于PRED+AZA。
Objective To evaluate the efficacy and safety of PRED+AZA treatment for autoimmune hepatitis(AIH)through Meta-analysis.[WTHZ]Methods Randomised controlled trials of PRED+AZA for AIH in PubMed,EmBase,Cochrane Library,CNKI,CBM,WanFang and VIP databases were searched.The quality of the included literature was evaluated.The complete remission rate,biochemical response rate,incidence of adverse events and mortality of patients treated in the literature were extracted and statistically analysed using RevMan 5.3 software.[WTHZ]Results A total of 11 publications were included,7 in English and 4 in Chinese.Meta-analysis showed that the control group had a higher rate of complete remission rate for AIH than PRED+AZA group(RR=0.79,95%CI:0.67-0.94,Z=2.69,P<0.05).Subgroup analysis showed no statistically significant difference in complete remission rate for AIH with PRED alone versus PRED+AZA(RR=0.81,95%CI:0.54-1.23,Z=0.97,P>0.05),and higher complete remission rate for AIH with Bude+AZA than PRED+AZA(RR=0.77,95%CI:0.63-0.93,Z=2.71,P<0.05).Compared to the control group,the biochemical remission rate,incidence of adverse events and mortality were not statistically significant(P>0.05).[WTHZ]Conclusion The complete remission efficacy of alternative treatments for AIH is superior to that of PRED+AZA,but there are no significant differences in biochemical remission,occurrence of adverse events,or death.The complete remission efficacy of PRED alone for the treatment of AIH is comparable to that of PRED+AZA,whereas the complete remission efficacy of Bude+AZA for the treatment of AIH is superior to that of PRED+AZA.
作者
杨秀英
党小红
姜洋
YANG Xiuying;DANG Xiaohong;JIANG Yang(The First Clinical Medical College of Shanxi Medical University,Taiyuan 030000;Department of Gastroenterology,First Hospital of Shanxi Medical University,China)
出处
《胃肠病学和肝病学杂志》
CAS
2024年第2期141-149,共9页
Chinese Journal of Gastroenterology and Hepatology
基金
中华国际科学交流基金会(Z2020LSXD05)。
