中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2014年
8期
585-589
,共5页
郑宜翔%马淑娟%谭德明%鲁猛厚
鄭宜翔%馬淑娟%譚德明%魯猛厚
정의상%마숙연%담덕명%로맹후
肝炎,乙型,慢性%抗结核%肝损害%Meta分析
肝炎,乙型,慢性%抗結覈%肝損害%Meta分析
간염,을형,만성%항결핵%간손해%Meta분석
Hepatitis B,chronic%Anti-tuberculosis%Liver lesions%Meta-analysis
目的 系统分析乙型肝炎患者在抗结核治疗时不同免疫状态对发生肝损害的影响. 方法 用循证医学的方法,用计算机在Pubmed、Embase、万方数据库、中国生物医学文献光盘数据库、中国期刊全文数据库中检索国内外公开发表的关于HBV携带者与非乙型肝炎患者抗结核治疗肝损害发生的病例对照研究,辅以手工检索.共纳入7篇文献,对于纳入文献中的乙型肝炎患者进一步分为HBeAg阳性组和HBeAg阴性组,与非乙型肝炎患者的抗结核治疗进行比较分析.采用x2检验和检验统计量I2对纳入的文献进行异质性检验;采用失安全系数对发表偏倚进行分析.结果 乙型肝炎患者在抗结核治疗时出现肝损害的危险性是非乙型肝炎患者的5.83倍(比值比为5.83,95％可信区间为4.27 ～ 7.95).而进一步亚组分析结果显示,HBeAg阳性免疫耐受期患者在抗结核治疗时发生肝损害的危险性是HBeAg阴性非活动性HBV携带者的2.10倍(比值比为2.10,95％可信区间为1.47 ～ 2.99).结论 HBV感染是抗结核治疗时发生肝损害的危险因素,HBeAg阳性的乙型肝炎患者相对其他免疫状态的乙型肝炎患者,其危险性更高.
目的 繫統分析乙型肝炎患者在抗結覈治療時不同免疫狀態對髮生肝損害的影響. 方法 用循證醫學的方法,用計算機在Pubmed、Embase、萬方數據庫、中國生物醫學文獻光盤數據庫、中國期刊全文數據庫中檢索國內外公開髮錶的關于HBV攜帶者與非乙型肝炎患者抗結覈治療肝損害髮生的病例對照研究,輔以手工檢索.共納入7篇文獻,對于納入文獻中的乙型肝炎患者進一步分為HBeAg暘性組和HBeAg陰性組,與非乙型肝炎患者的抗結覈治療進行比較分析.採用x2檢驗和檢驗統計量I2對納入的文獻進行異質性檢驗;採用失安全繫數對髮錶偏倚進行分析.結果 乙型肝炎患者在抗結覈治療時齣現肝損害的危險性是非乙型肝炎患者的5.83倍(比值比為5.83,95％可信區間為4.27 ～ 7.95).而進一步亞組分析結果顯示,HBeAg暘性免疫耐受期患者在抗結覈治療時髮生肝損害的危險性是HBeAg陰性非活動性HBV攜帶者的2.10倍(比值比為2.10,95％可信區間為1.47 ～ 2.99).結論 HBV感染是抗結覈治療時髮生肝損害的危險因素,HBeAg暘性的乙型肝炎患者相對其他免疫狀態的乙型肝炎患者,其危險性更高.
목적 계통분석을형간염환자재항결핵치료시불동면역상태대발생간손해적영향. 방법 용순증의학적방법,용계산궤재Pubmed、Embase、만방수거고、중국생물의학문헌광반수거고、중국기간전문수거고중검색국내외공개발표적관우HBV휴대자여비을형간염환자항결핵치료간손해발생적병례대조연구,보이수공검색.공납입7편문헌,대우납입문헌중적을형간염환자진일보분위HBeAg양성조화HBeAg음성조,여비을형간염환자적항결핵치료진행비교분석.채용x2검험화검험통계량I2대납입적문헌진행이질성검험;채용실안전계수대발표편의진행분석.결과 을형간염환자재항결핵치료시출현간손해적위험성시비을형간염환자적5.83배(비치비위5.83,95％가신구간위4.27 ～ 7.95).이진일보아조분석결과현시,HBeAg양성면역내수기환자재항결핵치료시발생간손해적위험성시HBeAg음성비활동성HBV휴대자적2.10배(비치비위2.10,95％가신구간위1.47 ～ 2.99).결론 HBV감염시항결핵치료시발생간손해적위험인소,HBeAg양성적을형간염환자상대기타면역상태적을형간염환자,기위험성경고.
Objective To evaluate the effect of different immune status on the incidence of hepatic lesions in patients with hepatitis B virus (HBV) infection undergoing anti-tuberculosis therapy.Methods The PubMed (1966-2013),Embase (1966-2013),Wanfang (1998-2013),Chinese National Knowledge Infrastructure (CNKI; 1997-2013),and Chinese Biomedical (CBMdisc; 1860-2013) literature databases were searched for case-control studies of hepatic lesions in patients undergoing anti-tuberculosis therapy with or without concomitant HBV infection.The HBV patients were divided into subgroups according to hepatitis B e antigen (HBeAg) positivity or negativity,all members of the control group were HBsAg (-).The data from all 7 studies included in the meta-analysis were extracted and analysed using RevMan5.2 soft-ware.Results Patients with HBV infection who were undergoing anti-tuberculosis therapy had a higher risk factor than the control patients (OR =5.81,95％ CI =[4.26,7.39]).The HBV patients with HBeAg positivity who were undergoing anti-tuberculosis therapy had a high risk factor than the HBV patients with HBeAg negativity (OR =2.56,95％ CI=[1.90,3.44]).Conclusion HBV infection is a risk factor for hepatic lesions when undergoing anti-tuberculosis therapy,and HBeAg-positive status may put a patient at higher risk.
