实用肝脏病杂志
實用肝髒病雜誌
실용간장병잡지
JOURNAL OF CLINICAL HEPATOLOGY
2015年
1期
24-29
,共6页
慢性乙型肝炎%聚乙二醇干扰素α-2a%阿德福韦酯%系统评价
慢性乙型肝炎%聚乙二醇榦擾素α-2a%阿德福韋酯%繫統評價
만성을형간염%취을이순간우소α-2a%아덕복위지%계통평개
Chronic hepatitis B%Peg-IFNα-2a%Adefovir%Meta analysis
目的:探讨聚乙二醇干扰素α-2a(Peg-IFNα-2a)联合阿德福韦(ADV)治疗HBeAg阳性慢性乙型肝炎(CHB)患者的临床疗效。方法通过检索2004年1月~2014年1月期间Pubmed、万方数据库(CECDB)、中文科技期刊数据库(VIP)、中国学术期刊全文数据库(CNKI)等有关Peg-IFNα-2a联合阿德福韦治疗HBeAg的CHB患者的随机对照试验(RCT),对纳入文献的质量进行严格评价和资料提取,应用Stata/SE version 12.0软件对纳入研究进行系统评价。结果最终纳入7篇RCT,共529例患者,其中实验组261例(接受Peg-IFNα-2a联合ADV治疗),对照组268例(接受Peg-IFNα-2a治疗)。系统评价结果显示,相比单药治疗,经联合治疗48 w时CHB患者HBV DNA阴转率显著提高[OR=1.20,95%CI=(1.01,1.43)];48 w时CHB患者HBeAg血清转换率显著提高[OR=1.24,95%CI=(1.02,1.52)],但联合治疗对ALT复常率的影响,系统评价显示结果存在显著偏倚[bias_P=0.012、bias_95 CI=(1.442998,6.467852)],不具有推广性。结论 Peg-IFNα-2a联合ADV治疗HBeAg阳性CHB患者能显著提高患者HBV DNA阴转率及HBeAg血清转换率。
目的:探討聚乙二醇榦擾素α-2a(Peg-IFNα-2a)聯閤阿德福韋(ADV)治療HBeAg暘性慢性乙型肝炎(CHB)患者的臨床療效。方法通過檢索2004年1月~2014年1月期間Pubmed、萬方數據庫(CECDB)、中文科技期刊數據庫(VIP)、中國學術期刊全文數據庫(CNKI)等有關Peg-IFNα-2a聯閤阿德福韋治療HBeAg的CHB患者的隨機對照試驗(RCT),對納入文獻的質量進行嚴格評價和資料提取,應用Stata/SE version 12.0軟件對納入研究進行繫統評價。結果最終納入7篇RCT,共529例患者,其中實驗組261例(接受Peg-IFNα-2a聯閤ADV治療),對照組268例(接受Peg-IFNα-2a治療)。繫統評價結果顯示,相比單藥治療,經聯閤治療48 w時CHB患者HBV DNA陰轉率顯著提高[OR=1.20,95%CI=(1.01,1.43)];48 w時CHB患者HBeAg血清轉換率顯著提高[OR=1.24,95%CI=(1.02,1.52)],但聯閤治療對ALT複常率的影響,繫統評價顯示結果存在顯著偏倚[bias_P=0.012、bias_95 CI=(1.442998,6.467852)],不具有推廣性。結論 Peg-IFNα-2a聯閤ADV治療HBeAg暘性CHB患者能顯著提高患者HBV DNA陰轉率及HBeAg血清轉換率。
목적:탐토취을이순간우소α-2a(Peg-IFNα-2a)연합아덕복위(ADV)치료HBeAg양성만성을형간염(CHB)환자적림상료효。방법통과검색2004년1월~2014년1월기간Pubmed、만방수거고(CECDB)、중문과기기간수거고(VIP)、중국학술기간전문수거고(CNKI)등유관Peg-IFNα-2a연합아덕복위치료HBeAg적CHB환자적수궤대조시험(RCT),대납입문헌적질량진행엄격평개화자료제취,응용Stata/SE version 12.0연건대납입연구진행계통평개。결과최종납입7편RCT,공529례환자,기중실험조261례(접수Peg-IFNα-2a연합ADV치료),대조조268례(접수Peg-IFNα-2a치료)。계통평개결과현시,상비단약치료,경연합치료48 w시CHB환자HBV DNA음전솔현저제고[OR=1.20,95%CI=(1.01,1.43)];48 w시CHB환자HBeAg혈청전환솔현저제고[OR=1.24,95%CI=(1.02,1.52)],단연합치료대ALT복상솔적영향,계통평개현시결과존재현저편의[bias_P=0.012、bias_95 CI=(1.442998,6.467852)],불구유추엄성。결론 Peg-IFNα-2a연합ADV치료HBeAg양성CHB환자능현저제고환자HBV DNA음전솔급HBeAg혈청전환솔。
Objective To investigate the clinical efficacy of pegylated interferon α-2a(Peg-IFNα-2a) com-bined with adefovir (ADV) in treatment of patients with HBeAg-positive chronic hepatitis B (CHB). Methods Randomized controlled trials (RCT) involving peg-IFNα-2a combined with adefovir in treatment of patients with HBeAg-positive CHB,were searched from Pubmed,Wanfang Database,Chongqing VIP database,CNKI database,etc, from January,2004 to January,2014,of which the quality were underwent rigorous assessment and data were ana-lyzed by Stata/SE software (version 12). Results 7 allegeable RCT (a total of 529 cases) were included. There were 261 patients receiving peg-IFNα-2a combined with ADV and 268 receiving peg-IFNα-2a alone. Systematic evaluation showed that HBV DNA negative rate in combinational therapy-treated patients with CHB at the end of week 48 was significantly higher as compared to patients receiving interferon alone[OR=1.20,95% CI=(1.01,1.43)];the HBeAg seroconversion rate at 48 w in patients receiving combinational therapy was also significantly higher than that in the controls [OR=1.24,95% CI=(1.02,1.52)];a significant bias of results was found for serum ALT normalization rate [bias_p=0.012,bias_95 CI=(1.442998,6.467852)]. Conclusions Peg-IFNα-2a combined with ADV significantly improves HBV DNA negative and HBeAg seroconversion rate in patients with HBeAg-positive CHB.