氨磷汀预防铂类神经毒性疗效与安全性的Meta分析

中国临床药理学与治疗学 ›› 2012, Vol. 17 ›› Issue (10): 1151-1156.

氨磷汀预防铂类神经毒性疗效与安全性的Meta分析

邓健浩^1,2, 史道华^1,2, 薛增贵¹, 肖淋¹

¹福建医科大学药学院,福州 350004,福建;
²福建省妇幼保健院药剂科,福州 350001,福建

收稿日期:2012-06-12 修回日期:2012-07-21 发布日期:2012-10-19
通讯作者: 史道华,通信作者,男,教授,硕士生导师,研究方向:临床药学和药理学。E-mail: shidh@yeah.net
作者简介:邓健浩,男,在读硕士研究生,研究方向:临床药学。Tel: 13459462265 E-mail: haozhi5266@163.com

Efficacy and safety of amifostine in preventing platinum-induced neurotoxicity: a meta-analysis

DENG Jian-hao^{1, 2}, SHI Dao-hua², XUE Zeng-gui¹, XIAO Lin¹

¹College of Pharmaceutical, Fujian Medical University, Fuzhou 350004, Fujian, China;
²Department of Pharmacology , Fujian Provincial Maternity and Children Health Hospital , Fuzhou 350001 , Fujian , China

Received:2012-06-12 Revised:2012-07-21 Published:2012-10-19

摘要/Abstract

摘要： 目的: 系统评价氨磷汀预防铂类神经毒性的临床疗效和安全性。方法: 计算机检索Cochrane图书馆、Pubmed、Embase、Cancerlit、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)和中文科技期刊全文数据库维普(VIP)、临床对照试验库,按照纳入与排出标准选择相关的随机对照试验,检索时间为1978年1月至2012年4月。在提取资料和评价质量后,用RevMan5.1.4软件进行Meta分析。结果: 共纳入11个研究,合计949例患者,其中英文6篇,中文5篇。Meta分析结果显示: 氨磷汀组能有效地减少神经毒性的发生[RR=0.57,95%CI(0.39,0.82),P=0.002],严重神经毒性的发生[RR=0.49,95%CI(0.29,0.84),P=0.009],加重呕吐的发生率[RR=1.36,95%CI(1.02,1.81),P=0.04],易发生低血压[RR=2.33,95%CI(1.29,4.23),P=0.005]。在恶心发生率[RR=1.20,95%CI(0.97,1.50),P=0.10]、头晕的发生率[RR=1.44,95%CI(0.50,4.12),P=0.50]上无统计学差异。结论: 氨磷汀与铂类药物化疗时联合应用能有效地预防铂类神经毒性的发生,但会加重呕吐的发生,并容易产生低血压等不良反应。

关键词: 氨磷汀, 铂类药物, 神经毒性, Meta分析

Abstract: AIM: To evaluate the efficacy and safety of amifostine in preventing platinum-induced neurotoxicity. METHODS: Retrieve from Cochrane Library, Pubmed, Emabase, Cancerlit, CBM, CNKI, VIP and Clinical Controlled Trials Database. Randomized controlled trials (RCT) were screened according to predefined inclusion and exclusion from the date of their establishment by april in 2012. Then the quality of the included trials was assessed and meta-analysis was performed by RevMan 5.1.4 software. RESULTS: A total of 11 studies involving 949 patients, six was English, while five was in Chinese. The resulted of meta-analyses showed that the experimental group was more effective than the control group in lowering the incidence of neurotoxicity[RR=0.57,95%CI(0.39,0.82),P=0.002], the incidence of severe neurotoxicity[RR=0.49,95%CI(0.29,0.84),P=0.009]; increasing the incidence of vomiting[RR=1.36,95%CI(1.02,1.81),P=0.04], the incidence of hypotention[RR=2.33,95%CI(1.29,4.23)P=0.005]. There were no significant difference between the experimental group and the control group in increasing the incidence of neusea[RR=1.20,95%CI(0.97,1.50),P=0.10]and dizziness[RR=1.44,95%CI(0.50,4.12),P=0.50]. CONCLUSION: Amifostine combine with platinum-based chemotherapy can effectively prevent the incidence of the neurotoxicity, but it will increase the incidence of vomiting and hypotention.

Key words: Amifostine, Platinum, Neurotoxicity, Meta-analysis

中图分类号:

R969

邓健浩, 史道华, 薛增贵, 肖淋. 氨磷汀预防铂类神经毒性疗效与安全性的Meta分析[J]. 中国临床药理学与治疗学, 2012, 17(10): 1151-1156.

DENG Jian-hao, SHI Dao-hua, XUE Zeng-gui, XIAO Lin. Efficacy and safety of amifostine in preventing platinum-induced neurotoxicity: a meta-analysis[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2012, 17(10): 1151-1156.

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