药学与临床研究
藥學與臨床研究
약학여림상연구
Pharmaceutical and Clinical Research
2015年
5期
456-461
,共6页
肖宇博%李荣凌%沈秉正%李萌%时晓晨
肖宇博%李榮凌%瀋秉正%李萌%時曉晨
초우박%리영릉%침병정%리맹%시효신
哌拉西林/他唑巴坦%延长输注%持续输注%meta分析
哌拉西林/他唑巴坦%延長輸註%持續輸註%meta分析
고랍서림/타서파탄%연장수주%지속수주%meta분석
Piperacillin/tazolbactam%Extended infusion%Continuous infusion%Meta-analysis
目的：通过meta分析比较哌拉西林/他唑巴坦（PTZ）改良输注（延长2~4 h或持续24 h输注）与传统输注（0.5~1 h输注）治疗严重感染患者的疗效及安全性。方法：在Medline、ScienceDirect、CNKI、VIP、万方数据库检索有关PTZ改良输注方式的临床研究，辅以手工检索。采用RevMan 5.0软件进行统计分析。结果：总共纳入15项临床研究。改良输注组死亡率明显低于传统输注组[RR=0.76，95% CI（0.63~0.92），P=0.004；I2=0%]，改良输注组有效率明显高于传统输注组[RR=1.11，95% CI（1.01~1.22），P=0.03；I2=53%]，而细菌清除率[RR=1.29，95% CI（0.76~2.21），P=0.35；I2=0%]及不良反应发生率[RR=1.22，95% CI（0.71~2.12），P=0.47；I2=0%]，两组均无明显差异。结论：延长或持续输注PTZ可以降低感染治疗的死亡风险、提高临床有效率。
目的：通過meta分析比較哌拉西林/他唑巴坦（PTZ）改良輸註（延長2~4 h或持續24 h輸註）與傳統輸註（0.5~1 h輸註）治療嚴重感染患者的療效及安全性。方法：在Medline、ScienceDirect、CNKI、VIP、萬方數據庫檢索有關PTZ改良輸註方式的臨床研究，輔以手工檢索。採用RevMan 5.0軟件進行統計分析。結果：總共納入15項臨床研究。改良輸註組死亡率明顯低于傳統輸註組[RR=0.76，95% CI（0.63~0.92），P=0.004；I2=0%]，改良輸註組有效率明顯高于傳統輸註組[RR=1.11，95% CI（1.01~1.22），P=0.03；I2=53%]，而細菌清除率[RR=1.29，95% CI（0.76~2.21），P=0.35；I2=0%]及不良反應髮生率[RR=1.22，95% CI（0.71~2.12），P=0.47；I2=0%]，兩組均無明顯差異。結論：延長或持續輸註PTZ可以降低感染治療的死亡風險、提高臨床有效率。
목적：통과meta분석비교고랍서림/타서파탄（PTZ）개량수주（연장2~4 h혹지속24 h수주）여전통수주（0.5~1 h수주）치료엄중감염환자적료효급안전성。방법：재Medline、ScienceDirect、CNKI、VIP、만방수거고검색유관PTZ개량수주방식적림상연구，보이수공검색。채용RevMan 5.0연건진행통계분석。결과：총공납입15항림상연구。개량수주조사망솔명현저우전통수주조[RR=0.76，95% CI（0.63~0.92），P=0.004；I2=0%]，개량수주조유효솔명현고우전통수주조[RR=1.11，95% CI（1.01~1.22），P=0.03；I2=53%]，이세균청제솔[RR=1.29，95% CI（0.76~2.21），P=0.35；I2=0%]급불량반응발생솔[RR=1.22，95% CI（0.71~2.12），P=0.47；I2=0%]，량조균무명현차이。결론：연장혹지속수주PTZ가이강저감염치료적사망풍험、제고림상유효솔。
Objective: To evaluate the efficacy and safety of alternative (extended 2-4 h or continuous 24 h infusion) and traditional dosing application of piperacillin/tazolbactam in the treatment of critically in-fected patients. Methods: Published articles were searched in MEDLINE, ScienceDirect, CNKI, VIP, and Wanfang database, supplemented by manual searches, to identify all the RCT and non-RCT of clinical re-searches aiming to explore the advantages of alternative infusion regimen of piperacillin/tazolbactam. The data processing was done with the RevMan 5.0 software. Results: Fifteen studies were included. Comparing with the intermittent infusion group, the alternative infusion group showed significantly higher rates of clini-cal success [RR=1.11, 95% CI (1.01-1.22), P=0.03; I2=53%] and lower mortality [RR=0.76,95% CI (0.63-0.92), P=0.004; I2=0%], but no significant difference in the rates of bacteriologic eradication [RR=1.29, 95% CI (0.76-2.21), P=0.35; I2=0%] or incidence of adverse drug reactions [RR=1.22, 95% CI (0.71-2.12), P=0.47; I2=0%]. Conclusion: Our study suggests that extended continuous infusion of piperacillin/tazolbac-tam is associated with lower mortality risk and higher clinical success rates. There is no significant safety difference between the alternative and intermittent infusions.
