临床儿科杂志
臨床兒科雜誌
림상인과잡지
2013年
8期
768-773
,共6页
抗-D免疫球蛋白%免疫球蛋白%紫癜%meta分析%儿童
抗-D免疫毬蛋白%免疫毬蛋白%紫癜%meta分析%兒童
항-D면역구단백%면역구단백%자전%meta분석%인동
anti-D immunoglobulin%immunoglobulin%purpura%meta-analysis%child
目的比较静脉注射抗-D免疫球蛋白（anti-D immunoglobulin，anti-D）与大剂量静脉注射免疫球蛋白（IVIG）治疗儿童急性特发性血小板减少性紫癜（ITP）的有效性及安全性。方法计算机检索PubMed、Embase和Cochrane Central Register of Controlled Trials。手工查阅计算机检索到的文献的参考文献目录。选取治疗72 h后血小板计数>20×109/L的百分率和血红蛋白下降值作为主要测量指标。采用RevMan 5.1对纳入文献进行meta分析。结果共检索到相关文献771篇，有5篇文献符合纳入标准。治疗72 h后anti-D组与IVIG组血小板计数>20×109/L比较差异有统计学意义（RR=0.90，95%CI：0.82～0.98）；亚组分析，anti-D 50μg/kg与IVIG比较，75μg/kg与IVIG比较，差异均无统计学意义（RR=0.98，95%CI：0.84～1.13；RR=0.88，95%CI：0.75～1.03）。anti-D组血红蛋白下降更明显，但患者均不需要输注悬浮红细胞。结论静脉注射anti-D治疗儿童急性ITP的疗效可能与大剂量IVIG相同。患者对anti-D的不良反应耐受性良好。
目的比較靜脈註射抗-D免疫毬蛋白（anti-D immunoglobulin，anti-D）與大劑量靜脈註射免疫毬蛋白（IVIG）治療兒童急性特髮性血小闆減少性紫癜（ITP）的有效性及安全性。方法計算機檢索PubMed、Embase和Cochrane Central Register of Controlled Trials。手工查閱計算機檢索到的文獻的參攷文獻目錄。選取治療72 h後血小闆計數>20×109/L的百分率和血紅蛋白下降值作為主要測量指標。採用RevMan 5.1對納入文獻進行meta分析。結果共檢索到相關文獻771篇，有5篇文獻符閤納入標準。治療72 h後anti-D組與IVIG組血小闆計數>20×109/L比較差異有統計學意義（RR=0.90，95%CI：0.82～0.98）；亞組分析，anti-D 50μg/kg與IVIG比較，75μg/kg與IVIG比較，差異均無統計學意義（RR=0.98，95%CI：0.84～1.13；RR=0.88，95%CI：0.75～1.03）。anti-D組血紅蛋白下降更明顯，但患者均不需要輸註懸浮紅細胞。結論靜脈註射anti-D治療兒童急性ITP的療效可能與大劑量IVIG相同。患者對anti-D的不良反應耐受性良好。
목적비교정맥주사항-D면역구단백（anti-D immunoglobulin，anti-D）여대제량정맥주사면역구단백（IVIG）치료인동급성특발성혈소판감소성자전（ITP）적유효성급안전성。방법계산궤검색PubMed、Embase화Cochrane Central Register of Controlled Trials。수공사열계산궤검색도적문헌적삼고문헌목록。선취치료72 h후혈소판계수>20×109/L적백분솔화혈홍단백하강치작위주요측량지표。채용RevMan 5.1대납입문헌진행meta분석。결과공검색도상관문헌771편，유5편문헌부합납입표준。치료72 h후anti-D조여IVIG조혈소판계수>20×109/L비교차이유통계학의의（RR=0.90，95%CI：0.82～0.98）；아조분석，anti-D 50μg/kg여IVIG비교，75μg/kg여IVIG비교，차이균무통계학의의（RR=0.98，95%CI：0.84～1.13；RR=0.88，95%CI：0.75～1.03）。anti-D조혈홍단백하강경명현，단환자균불수요수주현부홍세포。결론정맥주사anti-D치료인동급성ITP적료효가능여대제량IVIG상동。환자대anti-D적불량반응내수성량호。
Objectives To compare the effectiveness and safety of intravenous anti-D immunoglobulin (IV anti-D) with high-dose intravenous immunoglobulin (IVIG) as initial treatments of acute idiopathic thrombocytopenic purpura (ITP) in children. Methods Randomized controlled trials comparing anti-D with high-dose IVIG in the treatment of childhood acute ITP were systematically reviewed from PubMed, Embase and Cochrane Central Register of Controlled Trials and hand-searched reference lists. The number of patients with a platelet count>20 × 109/L at 72 hours after treatment initia-tion, and the decrease in hemoglobin were the primary outcomes. The meta-analysis was performed by RevMan 5.1. Results A total of 771 relevant articles were retrieved, and ifve studies were included. The RR (anti-D versus high dose IVIG) of achieving a platelet count>20×109/L at 72 hours was 0.90 (95%CI:0.82~0.98). However, subgroup analysis suggested no signiifcant difference between anti-D at a dose of 50μg/kg and high-dose IVIG (RR 0.98, 95% CI: 0.84~1.13), as well as between anti-D at a dose of 75μg/kg and high-dose IVIG (RR 0.88, 95%CI:0.75~1.03). Hemoglobin drop was greater in the anti-D group. No patients, however, required transfusions of erythrocyte suspensions. Conclusions IV anti-D may be as ef-fective as high-dose IVIG in the treatment of childhood acute ITP at 72 hours after therapy. The side effects of anti-D were tolerated and acceptable.
