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中国临床药理学与治疗学 ›› 2012, Vol. 17 ›› Issue (1): 64-68.

• 定量药理学 • 上一篇    下一篇

米卡芬净治疗真菌感染的疗效与安全性的Meta分析

吴家利, 刘文华, 尹平   

  1. 华中科技大学同济医学院公共卫生学院流行病与卫生统计学系, 武汉 430030, 湖北
  • 收稿日期:2011-10-11 修回日期:2011-11-14 出版日期:2012-01-26 发布日期:2012-02-16
  • 通讯作者: 尹平, 男, 硕士生导师, 研究方向: 生物统计学方法与应用。Tel: 027-83692832 E-mail: ping_y2000@163.com
  • 作者简介:吴家利, 女, 在读硕士研究生, 研究方向: 生物统计学方法与应用。Tel: 027-83692832 E-mail: wujiali86@126.com

Efficacy and safety of micafungin for the treatment of fungal infections: a Meta-analysis of seven randomized controlled study

WU Jia-li, LIU Wen-hua, YIN Ping   

  1. Department of Epidemiology and Health Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science&Technology, Wuhan 430030, Hubei, China
  • Received:2011-10-11 Revised:2011-11-14 Online:2012-01-26 Published:2012-02-16

摘要: 目的: 通过对米卡芬净治疗真菌感染的临床随机对照试验进行Meta分析, 探讨米卡芬净的有效性和安全性,为指导临床合理使用抗真菌药物提供参考依据。方法: 检索数据库Web of Science、EMBASE、Pubmed、Cochrane Library临床试验资料库、美国临床试验登记中心、中国生物医学文献数据库和中国期刊网从建库至2011年3月31日的所有相关文献及参考文献,应用RevMan5.0进行系统评价。结果: 共检索到181篇文献记录,经纳入排除标准筛选出7篇文献。有效性评价结果显示,米卡芬净的抗菌效果优于氟康唑(P=0.008),但与脂质两性霉素B的抗菌效果差异没有统计学意义(P=0.38)。米卡芬净与对照组在治疗不同类型念珠菌感染上的疗效差异没有统计学意义(P>0.05)。安全性评价结果显示,米卡芬净组与氟康唑组不良事件发生率差异没有统计学意义(P=0.40),与脂质两性霉素B的不良事件发生率差异没有统计学意义(P=0.06),但输注相关反应发生率低于脂质两性霉素B(P=0.001)。结论: 米卡芬净是氟康唑和脂质两性霉素B的良好的替代用药。本研究可能存在一定的发表偏倚,所得结果还需国内研究数据的进一步证实。

关键词: 米卡芬净, 真菌感染, 随机对照试验, Meta分析

Abstract: AIM: To study the efficacy and safety of micafungin by Meta-analysis, providing a reference guide for the clinical use of antifungal agents.METHODS: The database was retrieved from Web of Science, EMBASE, Pubmed, the Cochrane Library, ClinicalTrials.Gov, Chinese Biomedical Literature Database, China Journal Full Text Database, and references of the included studies up to March 2011. Data were evaluated by RevMan 5.0 from the Cochrane Collaboration.RESULTS: Seven RCTS were included. The results of effectiveness evaluation showed that, the antibacterial effect of micafungin was superior to fluconazole (P=0.008) but had no statistically significant differences with lipid amphotericin B (P=0.38). There were no statistically significant differences between micafungin and control group in different types of Candida infection (P>0.05). The results of safety evaluation showed that there were no statistically significant differences between micafungin and fluconazole (P=0.40) or lipid amphotericin B (P=0.06) group in the incidence of adverse events. However, the incidence of infusion-related reactions in micafungin group were less than lipid amphotericin B group (P=0.001).CONCLUSION: Micafungin is a good alternative medication to lipid amphotericin B and fluconazole. There may be some publication bias in this study, so the results needs to be further confirmed by domestic research.

Key words: Micafungin, Fungal infections, Randomized controlled trials, Meta analysis

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