中国医院用药评价与分析
中國醫院用藥評價與分析
중국의원용약평개여분석
EVALUATION AND ANAL YSIS OF DRUG-USE IN HOSPITALS OF CHINA
2015年
4期
445-449,450
,共6页
曹睿%王海雪%钟小燕%杨丹%叶云
曹睿%王海雪%鐘小燕%楊丹%葉雲
조예%왕해설%종소연%양단%협운
浅表性膀胱癌%丝裂霉素%卡介苗%系统评价%Meta分析
淺錶性膀胱癌%絲裂黴素%卡介苗%繫統評價%Meta分析
천표성방광암%사렬매소%잡개묘%계통평개%Meta분석
Uperficial bladder cancer%Mitomycin C%Bacillus Calmette-Guerin%Systematic review%Meta analysis
目的:系统评价丝裂霉素与卡介苗膀胱灌注预防浅表性膀胱癌的有效性和安全性。方法:计算机检索 PubMed、MEDLINE( Ovid)、EMBASE、Cochrane Library、CNKI、维普、万方等数据库,查找丝裂霉素( MMC)与卡介苗( BCG)单独膀胱灌注预防浅表性膀胱癌的随机对照试验( RCT),检索时限均从建库至2013年6月31日。由2名研究者按照纳入、排除标准独立筛选文献、提取资料和质量评价后,采用RevMan5.2软件进行Meta分析。结果:纳入12个RCT,共2602例患者。 Meta分析结果显示,应用MMC单独膀胱灌注预防浅表性膀胱癌( MMC组)的首次复发率、3年复发率、疾病进展、死亡率与应用BCG( BCG组)比较,差异无统计学意义([RR=0.99,95%CI(0.85,1.14),P=0.86];[RR=0.89,95%CI(0.71,1.13),P=0.35];[RR=0.85,95%CI (0.64,1.13),P=0.27];[RR=1.12,95%CI(0.76,1.64),P=0.57])。在药物不良反应方面,MMC组血尿、发热、排尿困难的发生率显著低于BCG组([RR=0.34,95%CI(0.16,0.71),P=0.004];[RR=0.14,95%CI(0.06,0.32),P<0.00001];[RR=0.71,95%CI(0.58,0.86),P=0.0006])。结论:膀胱灌注预防浅表性膀胱癌MMC的首次复发率、3年复发率、疾病进展、死亡率与BCG相似,安全性优于BCG。
目的:繫統評價絲裂黴素與卡介苗膀胱灌註預防淺錶性膀胱癌的有效性和安全性。方法:計算機檢索 PubMed、MEDLINE( Ovid)、EMBASE、Cochrane Library、CNKI、維普、萬方等數據庫,查找絲裂黴素( MMC)與卡介苗( BCG)單獨膀胱灌註預防淺錶性膀胱癌的隨機對照試驗( RCT),檢索時限均從建庫至2013年6月31日。由2名研究者按照納入、排除標準獨立篩選文獻、提取資料和質量評價後,採用RevMan5.2軟件進行Meta分析。結果:納入12箇RCT,共2602例患者。 Meta分析結果顯示,應用MMC單獨膀胱灌註預防淺錶性膀胱癌( MMC組)的首次複髮率、3年複髮率、疾病進展、死亡率與應用BCG( BCG組)比較,差異無統計學意義([RR=0.99,95%CI(0.85,1.14),P=0.86];[RR=0.89,95%CI(0.71,1.13),P=0.35];[RR=0.85,95%CI (0.64,1.13),P=0.27];[RR=1.12,95%CI(0.76,1.64),P=0.57])。在藥物不良反應方麵,MMC組血尿、髮熱、排尿睏難的髮生率顯著低于BCG組([RR=0.34,95%CI(0.16,0.71),P=0.004];[RR=0.14,95%CI(0.06,0.32),P<0.00001];[RR=0.71,95%CI(0.58,0.86),P=0.0006])。結論:膀胱灌註預防淺錶性膀胱癌MMC的首次複髮率、3年複髮率、疾病進展、死亡率與BCG相似,安全性優于BCG。
목적:계통평개사렬매소여잡개묘방광관주예방천표성방광암적유효성화안전성。방법:계산궤검색 PubMed、MEDLINE( Ovid)、EMBASE、Cochrane Library、CNKI、유보、만방등수거고,사조사렬매소( MMC)여잡개묘( BCG)단독방광관주예방천표성방광암적수궤대조시험( RCT),검색시한균종건고지2013년6월31일。유2명연구자안조납입、배제표준독립사선문헌、제취자료화질량평개후,채용RevMan5.2연건진행Meta분석。결과:납입12개RCT,공2602례환자。 Meta분석결과현시,응용MMC단독방광관주예방천표성방광암( MMC조)적수차복발솔、3년복발솔、질병진전、사망솔여응용BCG( BCG조)비교,차이무통계학의의([RR=0.99,95%CI(0.85,1.14),P=0.86];[RR=0.89,95%CI(0.71,1.13),P=0.35];[RR=0.85,95%CI (0.64,1.13),P=0.27];[RR=1.12,95%CI(0.76,1.64),P=0.57])。재약물불량반응방면,MMC조혈뇨、발열、배뇨곤난적발생솔현저저우BCG조([RR=0.34,95%CI(0.16,0.71),P=0.004];[RR=0.14,95%CI(0.06,0.32),P<0.00001];[RR=0.71,95%CI(0.58,0.86),P=0.0006])。결론:방광관주예방천표성방광암MMC적수차복발솔、3년복발솔、질병진전、사망솔여BCG상사,안전성우우BCG。
OBJECTIVE:To evaluate the efficacy and safety of intravesical mitomycin C ( MMC) versus Bacillus Calmette-Guerin ( BCG) for superficial bladder cancer.METHODS: The literature about randomized controlled trials ( RCTs ) on intravesical MMC versus BCG for superficial bladder cancer were retrieved from databases such as PubMed, EMbase, CBM, the Cochrane Library, CNKI, VIP and WanFang Data ( from the date of their establishment to June 30, 2013 ) .According to the inclusion and exclusion criteria, two reviewers independently screened the literature, extracted data and assessed the quality of the included studies.Meta-analysis was conducted using RevMan 5.2 software.RESULTS: A total of 12 RCTs involving 2 602 patients were included.The results of meta-analysis showed that there were no statistically significant differences regarding the first time recurrence rate, 3-years recurrence rate, disease progression, and mortality between MMC group and BCG group [ RR=0.99, 95% CI (0.85, 1.14), P=0.86;RR=0.89, 95%CI (0.71, 1.13), P=0.35;RR=0.85, 95%CI (0.64, 1.13), P=0.27;RR=1.12,95%CI (0.76, 1.64) , P=0.57] .The incidences of hematuria, fever, dysuria in MMC group was lower than in the BCG group [RR =0.34,95%CI (0.16, 0.71), P =0.004; RR =0.14, 95%CI (0.06, 0.32), P﹤0.00001;RR=0.71,95%CI (0.58, 0.86), P=0.0006].CONCLUSION: The first time recurrence rate, 3-year recurrence rate, disease progression and mortality were similar between MMC group and BCG group, but MMC is safer than BCG.