国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2014年
14期
1069-1074
,共6页
肺间质纤维化%沙利度胺%系统评价%Meta分析%随机对照试验
肺間質纖維化%沙利度胺%繫統評價%Meta分析%隨機對照試驗
폐간질섬유화%사리도알%계통평개%Meta분석%수궤대조시험
Pulmonary fibrosis%Thalidomide%Systematic review%Meta-analysis%Randomized controlled trial
目的 系统评价沙利度胺治疗肺间质纤维化的疗效.方法 计算机检索PubMed(1954～2013.8)、EMbase(1954～2013.8)、The Cochrane Library、CNKI(1979～2013.8)、VIP(1989～2013.8)、CBM(1954～2013.8)和WanFang Data(1998～2013.8),查找沙利度胺治疗肺纤维化的随机对照试验.由2名评价者按纳入和排除标准独立筛选文献、提取资料和质量评价后,采用RevMan 5.2版软件进行Meta分析.结果 最终共纳入5篇文献,4个随机对照试验,206例患者.Meta分析结果显示:所有结局指标,包括临床疗效(RR =2.00,95％CI:1.37～2.94,P=0.000 4),干咳的改善(MD =-11.50,95％CI:-19.79～-3.21,P=0.007),肺部病变吸收率(RR =1.87,95％CI:1.35～2.59,P=0.000 2),肺功能FVC(SMD =0.83,95％ CI:0.49～1.16,P＜0.000 01),FEV1/FVC(SMD =0.75,95％CI:0.41～1.08,P＜0.000 1),细胞因子肿瘤坏死因子α(SMD=-0.93,95％CI:-1.35～-0.51,P＜0.000 1),转化生长因子β1(SMD=-0.57,95％ CI:-0.97～-0.16,P=0.007),沙利度胺组均优于对照组.结论 沙利度胺可以改善肺间质纤维化患者的肺功能、肺部病变吸收情况、BALF中转化生长因子β1及肿瘤坏死因子α水平及干咳等症状,从而提高患者的生活质量.但受纳入研究数量和质量的限制,因此上述结论尚有待开展更多高质量大样本的随机对照试验来进一步验证.
目的 繫統評價沙利度胺治療肺間質纖維化的療效.方法 計算機檢索PubMed(1954～2013.8)、EMbase(1954～2013.8)、The Cochrane Library、CNKI(1979～2013.8)、VIP(1989～2013.8)、CBM(1954～2013.8)和WanFang Data(1998～2013.8),查找沙利度胺治療肺纖維化的隨機對照試驗.由2名評價者按納入和排除標準獨立篩選文獻、提取資料和質量評價後,採用RevMan 5.2版軟件進行Meta分析.結果 最終共納入5篇文獻,4箇隨機對照試驗,206例患者.Meta分析結果顯示:所有結跼指標,包括臨床療效(RR =2.00,95％CI:1.37～2.94,P=0.000 4),榦咳的改善(MD =-11.50,95％CI:-19.79～-3.21,P=0.007),肺部病變吸收率(RR =1.87,95％CI:1.35～2.59,P=0.000 2),肺功能FVC(SMD =0.83,95％ CI:0.49～1.16,P＜0.000 01),FEV1/FVC(SMD =0.75,95％CI:0.41～1.08,P＜0.000 1),細胞因子腫瘤壞死因子α(SMD=-0.93,95％CI:-1.35～-0.51,P＜0.000 1),轉化生長因子β1(SMD=-0.57,95％ CI:-0.97～-0.16,P=0.007),沙利度胺組均優于對照組.結論 沙利度胺可以改善肺間質纖維化患者的肺功能、肺部病變吸收情況、BALF中轉化生長因子β1及腫瘤壞死因子α水平及榦咳等癥狀,從而提高患者的生活質量.但受納入研究數量和質量的限製,因此上述結論尚有待開展更多高質量大樣本的隨機對照試驗來進一步驗證.
목적 계통평개사리도알치료폐간질섬유화적료효.방법 계산궤검색PubMed(1954～2013.8)、EMbase(1954～2013.8)、The Cochrane Library、CNKI(1979～2013.8)、VIP(1989～2013.8)、CBM(1954～2013.8)화WanFang Data(1998～2013.8),사조사리도알치료폐섬유화적수궤대조시험.유2명평개자안납입화배제표준독립사선문헌、제취자료화질량평개후,채용RevMan 5.2판연건진행Meta분석.결과 최종공납입5편문헌,4개수궤대조시험,206례환자.Meta분석결과현시:소유결국지표,포괄림상료효(RR =2.00,95％CI:1.37～2.94,P=0.000 4),간해적개선(MD =-11.50,95％CI:-19.79～-3.21,P=0.007),폐부병변흡수솔(RR =1.87,95％CI:1.35～2.59,P=0.000 2),폐공능FVC(SMD =0.83,95％ CI:0.49～1.16,P＜0.000 01),FEV1/FVC(SMD =0.75,95％CI:0.41～1.08,P＜0.000 1),세포인자종류배사인자α(SMD=-0.93,95％CI:-1.35～-0.51,P＜0.000 1),전화생장인자β1(SMD=-0.57,95％ CI:-0.97～-0.16,P=0.007),사리도알조균우우대조조.결론 사리도알가이개선폐간질섬유화환자적폐공능、폐부병변흡수정황、BALF중전화생장인자β1급종류배사인자α수평급간해등증상,종이제고환자적생활질량.단수납입연구수량화질량적한제,인차상술결론상유대개전경다고질량대양본적수궤대조시험래진일보험증.
Objective To systematically evaluate the effectiveness of thalidomide for patients with pulmonary fibrosis (PF).Methods The randomized controlled trials (RCTs) about thalidomide for patients with PF were searched in following databases:PubMed (1954-2013.8),EMbase(1954-2013.8),The Cochrane Library,CNKI(1979-2013.8),VIP(1989-2013.8),CBM(1954-2013.8),and WanFang Data (1998-2013.8).Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted the data,and assessed the quality,and then the meta-analysis was performed using RevMan 5.2 software.Results A total of four RCTs including 206 PF patients were included.The results of meta-analysis demonstrated that,the thalidomide group was superior to control group in aspects of clinical curative effect (RR =2.00,95 ％ CI:1.37-2.94,P =0.000 4),the improvement of the cough (MD =-11.50,95％ CI:-19.79--3.21,P =0.007),the absorption of lung lesions (RR =1.87,95％ CI:1.35-2.59,P =0.000 2),FVC (SMD =0.83,95％ CI:0.49-1.16,P ＜0.000 01),FEV1/FVC (SMD =0.75,95％CI:0.41-1.08,P ＜0.000 1),tumor necrosis factor-α (SMD =-0.93,95％ CI:-1.35--0.51,P ＜0.000 1),transforming growth factor-β1 (SMD =-0.57,95％ CI:-0.97-0.16,P =0.007).Conclusions Thalidomide for PF patients can significantly improve the pulmonary function,the absorption of lung lesions,the levels of cytokines in bronchoalveolar lavage fluid,and clinical symptoms such as cough.Due to the quantity and quality limitation of included studies,this conclusion still needs to be further proved by higher quality and double blind RCTs.
