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中国防痨杂志 ›› 2020, Vol. 42 ›› Issue (6): 570-577.doi: 10.3969/j.issn.1000-6621.2020.06.007

• 论著 • 上一篇    下一篇

胸腺五肽辅助治疗复治菌阳肺结核疗效和安全性的Meta分析

黄国军*, 高源, 唐细良, 高晓, 白丽琼()   

  1. 410013 长沙,湖南省结核病防治所 湖南省胸科医院(黄国军、唐细良、白丽琼);School of Public Health, University of Adelaide, Australia(高源);中南大学湘雅公共卫生学院流行病与卫生统计学系(高晓)
  • 收稿日期:2019-11-30 出版日期:2020-06-10 发布日期:2020-06-11
  • 通信作者: 白丽琼 E-mail:liqiong99@126.com
  • 基金资助:
    “艾滋病和病毒性肝炎等重大传染病防治”科技重大专项(2018ZX10722301-004);湖南省科技创新平台与人才计划(2018SK7003)

Efficacy and safety of thymopentin in adjuvant treatment of retreatment positive pulmonary tuberculosis: a Meta-analysis

HUANG Guo-jun*, GAO Yuan, TANG Xi-liang, GAO Xiao, BAI Li-qiong()   

  1. *Hu’nan Institute for Tuberculosis Control and Hu’nan Chest Hospital, Changsha 410013, China
  • Received:2019-11-30 Online:2020-06-10 Published:2020-06-11
  • Contact: BAI Li-qiong E-mail:liqiong99@126.com

摘要:

目的 系统评价胸腺五肽辅助治疗复治菌阳肺结核的疗效和安全性。方法 采用在线检索的方法,检索PubMed、the Cochrane Library、中国生物医学文献数据库、万方数据库、中国知网、维普中文科技期刊数据库,检索时间从建库至2019年8月1日。中文检索词:胸腺五肽、肺结核;英文检索词:thymopentin、pulmonary tuberculosis。按照检索策略,初步检索到相关文献326篇,其中,中文文献322篇,英文文献4篇,最终纳入18篇。采用RevMan 5.3软件对复治菌阳肺结核2个月末痰菌阴转率,6个月末痰菌阴转率、病灶吸收率、空洞闭合率,药物不良反应发生率,CD4 +和CD8 +T淋巴细胞水平进行分析。结果 Meta分析结果显示,与常规治疗方案相比,胸腺五肽辅助治疗复治菌阳肺结核可提高患者治疗2个月末痰菌阴转率[风险比(RR)(95%CI)=1.28(1.17~1.40)]、6个月末痰菌阴转率[RR(95%CI)=1.24(1.18~1.29)]、病灶吸收率[RR(95%CI)=1.27(1.19~1.37)],以及空洞闭合率[RR(95%CI)=1.39(1.26~1.54)];而药物不良反应发生率差异无统计学意义[RR(95%CI)=0.82(0.63~1.07)]。胸腺五肽辅助治疗复治菌阳肺结核能提升患者的CD4 +T淋巴细胞水平[加权均数差(WMD)(95%CI)=11.03(8.79~13.27)],降低CD8 +T淋巴细胞水平[WMD(95%CI)=-8.34(-12.54~-4.14)],提升CD4 +/CD8 +水平[WMD(95%CI)=0.51(0.26~0.75)]。结论 胸腺五肽辅助治疗复治菌阳肺结核安全有效。

关键词: 胸腺生成素类, 结核, 肺, 治疗应用, Meta分析

Abstract:

Objective To systematically assess the efficacy and safety of thymopentin in adjuvant treatment of retreatment pulmonary tuberculosis. Methods The PubMed, the Cochrane Library, Sinomed, CNKI, Wanfang and VPCS database were retrieved online from the establishment of database to Aug 1st 2019. Both Chinese and English retrieval words were thymopentin and pulmonary tuberculosis. According to the retrieval strategies, a total of 326 related literatures were initially retrieved, including 322 in Chinese, and 4 in English. Finally, 18 studies were included in this study. The RevMan 5.3 was adopted in analysis on the sputum conversion rate of the treatment after 2 months and 6 months, the foci absorption rate, the cavity closure rate, the incidence of adverse events, the CD4 + level and CD8 + level of the retreatment positive pulmonary tuberculosis. Results Meta-analysis showed that compared with conventional treatments, thymopentin in adjuvant treatment of retreatment positive pulmonary tuberculosis could significantly enhance the sputum conversion rate after 2 months of treatment (RR (95%CI)=1.28 (1.17-1.40)), and 6 months of treatment (RR (95%CI)=1.24 (1.18-1.29)). The foci absorption rate (RR (95%CI)=1.27 (1.19-1.37)) and the cavity closure rate (RR (95%CI)=1.39 (1.26-1.54)) were also improved. There was no statistical significance in incidence of adverse events (RR (95%CI)=0.82 (0.63-1.07)). Analysis also indicated that CD4 + level (WMD (95%CI)=11.03 (8.79-13.27)) and CD4 +/CD8 + level (WMD (95%CI)=0.51 (0.26-0.75)) were improved, while CD8 + level (WMD (95%CI)=-8.34 (-12.54--4.14)) decreased. Conclusion The current evidence shows that thymopentin is safe and effective in adjuvant treatment of retreatment positive pulmonary tuberculosis.

Key words: Thymopoietins, Tuberculosis, pulmonary, Therapeutic uses, Meta-analysis