CAJ | 학술논문

目的系统评价更昔洛韦防治肾移植后巨细胞病毒(cytomegalovirus,CMV)感染的有效性.方法计算机检索PubMed、SCI、EMBASE、Cochrane Library、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库和中华医学会数字化期刊群,并辅手工检索和其他检索,收集肾移植后给予更昔洛韦防治CMV感染的随机对照试验,检索时间截止到2009年6月.按照纳入标准由2名研究者独立筛选文献并提取资料,采用Cochrane Handbook推荐评价标准评价纳入研究质量,采用RevMan 5.0软件进行统计处理.结果共纳入12个随机对照试验.Meta分析结果显示:(1)与不服用抗病毒药相比,更昔洛韦并不能降低术后3个月和6个月CMV感染率和CMV发病率,但可降低12个月CMV发病率,可以延缓术后发生CMV感染的时间;(2)与伐昔洛韦相比,两者降低CMV感染率和发病率的差别不大;(3)与阿昔洛韦比较,更昔洛韦可降低6个月CMV发病率;(4)与抗CMV-IgG和缬更昔洛韦比较,在降低CMV发病率方面在统计学上无显著性差异(P=0.93;P=0.14).结论对肾移植患者给予长时间更昔洛韦可以预防CMV感染,其疗效与伐昔洛韦、抗CMV-IgG、缬更昔洛韦无区别,较阿昔洛韦好.
목적 계통평개경석락위방치신이식후거세포병독(cytomegalovirus,CMV)감염적유효성.방법 계산궤검색PubMed、SCI、EMBASE、Cochrane Library、중국기간전문수거고、중국생물의학문헌수거고、중문과기기간수거고화중화의학회수자화기간군,병보수공검색화기타검색,수집신이식후급여경석락위방치CMV감염적수궤대조시험,검색시간절지도2009년6월.안조납입표준유2명연구자독립사선문헌병제취자료,채용Cochrane Handbook추천평개표준평개납입연구질량,채용RevMan 5.0연건진행통계처리.결과 공납입12개수궤대조시험.Meta분석결과현시:(1)여불복용항병독약상비,경석락위병불능강저술후3개월화6개월CMV감염솔화CMV발병솔,단가강저12개월CMV발병솔,가이연완술후발생CMV감염적시간;(2)여벌석락위상비,량자강저CMV감염솔화발병솔적차별불대;(3)여아석락위비교,경석락위가강저6개월CMV발병솔;(4)여항CMV-IgG화힐경석락위비교,재강저CMV발병솔방면재통계학상무현저성차이(P=0.93;P=0.14).결론 대신이식환자급여장시간경석락위가이예방CMV감염,기료효여벌석락위、항CMV-IgG、힐경석락위무구별,교아석락위호.
Objective To assess the efficacy of ganciclovir to prevent and cure cytomegalovirus (CMV) infection after renal transplantation. Methods We searched PubMed, EMBASE, Cochrane Library, SCI, China Academic Journals Full-text Databases, Chinese Biomedical Literature Database, Chinese Scientific Journals Databases and Chinese Medical Association Journals to collect randomized controlled trials of ganciclovir to prevent and cure CMV infection after renal transplantation (up to June, 2009). Two reviewers extracted data independently using a designed extraction form. The quality of included trials was evaluated according to the Cochrane Handbook. RevMan 5.0 software was used for data analysis. Results Twelve randomized controlled trials were included. The results of meta-analysis showed that: ①Compared with no receive antiviral agents, ganciclovir couldn't lower CMV infection rate and disease rate in 3 months and 6 months after renal transplantation, but could lower CMV disease rate in 12 months. The delay between transplantation and CMV infection was significantly longer. ②Either valaciclovir or ganciclovir could lower CMV infection rate and disease rate after renal transplantation, without statistical difference. ③Compared with acyclovir, ganciclovir could lower CMV disease rate in 6 months after renal transplantation. ④Compared with CMV-IgG and valganciclovir, ganciclovir didn't have statistical difference in decreasing CMV disease rate (P=0.93;P=0.14). Conclusions Longer prophylaxis by ganciclovior may prevent CMV infection after renal transplantation. Its curative effect is similar to valaciclovir, CMV-IgG and valganciclovir, but better than acyclovir.