肝炎,乙型,慢性%干扰素%胸腺肽α1%荟萃分析
肝炎,乙型,慢性%榦擾素%胸腺肽α1%薈萃分析
간염,을형,만성%간우소%흉선태α1%회췌분석
Hepatitis B,chronic%Interferon%Thymosin alpha-1%Meta-analysis
目的 评价干扰素联合胸腺肽α1治疗HBeAg阳性慢性乙型肝炎的疗效与安全性.方法 检索PubMed、EBSCO、Cochrane Library、中国生物医学文献光盘数据库、中国科技期刊数据库、万方数据库等,检索年限均从1990年1月-2010年5月,纳入干扰素联合胸腺肽α1与干扰素单药治疗HBeAg阳性慢性乙型肝炎且停药后随访时间至少6个月的随机对照试验.采用RevMan5.0软件进行荟萃分析,并根据不同观测时间点进行亚组分析.结果 经筛选共纳入7个随机对照试验,合计535例患者.荟萃分析结果显示,在治疗结束和随访结束时,联合治疗组的HBVDNA转阴率高于单药组[54.9%比36.3%,比值比(OR)=2.39,95%可信区间(CI)为1.64～3.49,P＜0.01 ; 58.6%比30.7%,OR=3.68,95%CI为2.51～5.41,P＜0.01],ALT复常率高于单药组(74.5%比60.9%,OR=1.94,95% CI为1.26～3.00,P＜0.01 ;74.0%比55.6%,OR=2.36,95% CI为1.54～3.62,P＜0.01),HBeAg转阴率高于单药组(56.9%比36.7%,OR=2.38,95% CI为1.61～3.51,P＜0.01 ; 62.2%比33.2%,OR=3.42,95% CI为2.31～5.06,P＜0.01),HBeAg血清转换率高于单药组(40.1%比29.0%,OR=1.65,95% CI为1.10～2.47,P＜0.05; 47.0%比29.5%,OR=2.13,95% CI为1.43～3.16,P＜0.01); HBsAg转阴率仅在随访结束时高于单药组(9.8%比3.7%,OR=2.92,95% CI为1.09～7.76,P＜0.05).结论 干扰素联合胸腺肽α1对于HBeAg阳性慢性乙型肝炎的抗病毒疗效优于干扰素单药治疗,且不良反应无明显增加.
目的 評價榦擾素聯閤胸腺肽α1治療HBeAg暘性慢性乙型肝炎的療效與安全性.方法 檢索PubMed、EBSCO、Cochrane Library、中國生物醫學文獻光盤數據庫、中國科技期刊數據庫、萬方數據庫等,檢索年限均從1990年1月-2010年5月,納入榦擾素聯閤胸腺肽α1與榦擾素單藥治療HBeAg暘性慢性乙型肝炎且停藥後隨訪時間至少6箇月的隨機對照試驗.採用RevMan5.0軟件進行薈萃分析,併根據不同觀測時間點進行亞組分析.結果 經篩選共納入7箇隨機對照試驗,閤計535例患者.薈萃分析結果顯示,在治療結束和隨訪結束時,聯閤治療組的HBVDNA轉陰率高于單藥組[54.9%比36.3%,比值比(OR)=2.39,95%可信區間(CI)為1.64～3.49,P＜0.01 ; 58.6%比30.7%,OR=3.68,95%CI為2.51～5.41,P＜0.01],ALT複常率高于單藥組(74.5%比60.9%,OR=1.94,95% CI為1.26～3.00,P＜0.01 ;74.0%比55.6%,OR=2.36,95% CI為1.54～3.62,P＜0.01),HBeAg轉陰率高于單藥組(56.9%比36.7%,OR=2.38,95% CI為1.61～3.51,P＜0.01 ; 62.2%比33.2%,OR=3.42,95% CI為2.31～5.06,P＜0.01),HBeAg血清轉換率高于單藥組(40.1%比29.0%,OR=1.65,95% CI為1.10～2.47,P＜0.05; 47.0%比29.5%,OR=2.13,95% CI為1.43～3.16,P＜0.01); HBsAg轉陰率僅在隨訪結束時高于單藥組(9.8%比3.7%,OR=2.92,95% CI為1.09～7.76,P＜0.05).結論 榦擾素聯閤胸腺肽α1對于HBeAg暘性慢性乙型肝炎的抗病毒療效優于榦擾素單藥治療,且不良反應無明顯增加.
목적 평개간우소연합흉선태α1치료HBeAg양성만성을형간염적료효여안전성.방법 검색PubMed、EBSCO、Cochrane Library、중국생물의학문헌광반수거고、중국과기기간수거고、만방수거고등,검색년한균종1990년1월-2010년5월,납입간우소연합흉선태α1여간우소단약치료HBeAg양성만성을형간염차정약후수방시간지소6개월적수궤대조시험.채용RevMan5.0연건진행회췌분석,병근거불동관측시간점진행아조분석.결과 경사선공납입7개수궤대조시험,합계535례환자.회췌분석결과현시,재치료결속화수방결속시,연합치료조적HBVDNA전음솔고우단약조[54.9%비36.3%,비치비(OR)=2.39,95%가신구간(CI)위1.64～3.49,P＜0.01 ; 58.6%비30.7%,OR=3.68,95%CI위2.51～5.41,P＜0.01],ALT복상솔고우단약조(74.5%비60.9%,OR=1.94,95% CI위1.26～3.00,P＜0.01 ;74.0%비55.6%,OR=2.36,95% CI위1.54～3.62,P＜0.01),HBeAg전음솔고우단약조(56.9%비36.7%,OR=2.38,95% CI위1.61～3.51,P＜0.01 ; 62.2%비33.2%,OR=3.42,95% CI위2.31～5.06,P＜0.01),HBeAg혈청전환솔고우단약조(40.1%비29.0%,OR=1.65,95% CI위1.10～2.47,P＜0.05; 47.0%비29.5%,OR=2.13,95% CI위1.43～3.16,P＜0.01); HBsAg전음솔부재수방결속시고우단약조(9.8%비3.7%,OR=2.92,95% CI위1.09～7.76,P＜0.05).결론 간우소연합흉선태α1대우HBeAg양성만성을형간염적항병독료효우우간우소단약치료,차불량반응무명현증가.
Objective To compare the efficacy of interferon and thymosin alpha-1 combination therapy with interferon monotherapy for HBeAg positive chronic hepatitis B. Methods The relevant randomized controlled trials were searched throughout PubMed, EBSCO, Cochrane Library, CBMdisc, VIP,WanFang since Janurary 1990. Studies were included if patients were followed up for at least 6 months after cessation of treatment. Meta-analysis was carried out with RevMan5.0 software. Subgroup analyses were used at different time of observation. Results Seven randomized controlled trials were included(535 patients in total). According to the results of meta-analysis, the combination therapy was remarkably more effective than monotherapy both at the end of the treatment and the follow-up in terms of HBV-DNA negative rate(54.9% vs 36.3%, OR = 2.39, 95% CI = 1.64-3.49, P ＜ 0.01; 58.6% vs 30.7%, OR = 3.68, 95% CI = 2.51-5.41,P ＜ 0.01, respectively), ALT normalization rate (74.5% vs 60.9%, OR = 1.94, 95% CI = 1.26-3.00, P ＜ 0.01;74.0% vs 55.6%, OR = 2.36, 95% CI = 1.54-3.62, P ＜ 0.01, respectively), HBeAg loss rate (56.9% vs 36.7%,OR = 2.38, 95% CI = 1.61-3.51, P ＜ 0.01; 62.2% vs 33.2%, OR = 3.42, 95% CI = 2.31-5.06, P ＜ 0.01,respectively), and HBeAg seroconversion rate (40.1% vs 29.0%, OR = 1.65, 95% CI = 1.10-2.47, P ＜ 0.05;47.0% vs 29.5%, OR = 2.13, 95% CI = 1.43-3.16, P ＜ 0.01, respectively); the HBsAg loss rate of the combination therapy group was significantly higher than that of the monotherapy group only at the end of the follow-up (9.8% vs 3.7%, OR = 2.92, 95% CI = 1.09-7.76, P ＜ 0.05). Conclusion Interferon and thymosin alpha-1 combination therapy achieves superior effect with no increase in the adverse effects as compared to interferon monotherapy for HBeAg positive chronic hepatitis B.
