摘要
目的系统评价胸腔内注入重组人血管内皮素抑制剂（恩度）联合铂类制剂治疗恶性胸腔积液的疗效及安全性。方法采用Cochrane系统评价方法，对PubMed、Embase、Cochrane Library、CNKI、万方及维普数据库进行计算机检索，检索时间截止至2014年8月，研究对象为恶性胸腔积液患者，观察组胸腔内注入恩度联合铂类制剂，对照组胸腔内仅注入铂类制剂，研究内容为比较两组治疗疗效及不良反应发生情况。纳入研究的质量由两名研究者评估，采用RevMan5．3软件对研究进行meta分析。结果按照标准共纳入9篇文献，488例病例，9项研究均为临床随机对照研究。1篇文献质量为B级，8篇文献质量为C级。Meta分析表明，恩度联合铂类制剂胸腔内注入治疗恶性胸腔积液在有效率（OR=3．52，95％CI=2．37～5．22）、KPS计分改善率（OR=2．64，95％CI=1．67—4．19）方面优于单纯铂类制剂胸腔内注入，且治疗后白细胞减少（OR=1．0，95％CI：0．62～1．61）、恶心呕吐（OR=0．77，95％CI=0．43—1．38）发生率均与单纯注入铂类制剂组比较差异无统计学意义（P〉0．05）。结论当前证据表明，胸腔内注入恩度联合铂类制剂治疗恶性胸腔积液在提高有效率、改善生活质量方面均优于单纯注入铂类制剂，同时毒副作用增加不明显。由于本文纳入的研究较少，文献质量偏低，发生偏倚可能性较大，尚需高质量、大样本、多中心的随机对照试验进一步证实。
Objective To investigate the efficacy and safety of patients with malignant pleural effusion treated with injecting endostar combined with platinum complexes into pleural cavity. Methods Cochrane systematic review methods were used in the data selection, and data were selected from the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure （CNKI）, WanFang, and VIP database to get all clinical controlled trials. The retrieval time was August 2014. The objects of these randomized controlled trials were malignant pleural effusion patients. Endostar combination with platinum complexes was used for the experimental group. Platinum complexes alone were used for the control group. The efficacy and adverse effects of two groups were compared. The quality of included trials was evaluated by two reviewers independently. The software RevMan 5.3 was used for meta-analyses. Results Nine trials with 488 patients were included according to the including criterion. All trials were randomized controlled trials, one of them had B level in quality and eight had C level. Meta analysis results were as follows ： there was significant difference in overall effective rate （ OR = 3.52, 95% CI = 2. 37 ～5.22）, Karnofsky （KPS） score changes rate （ OR =2. 64, 95% CI = 1.67 ～ 4. 19 ）, between endostar combination with platinum complexes and platinum complexes alone group. The incidences of severe leucopenia （ OR = 1.0, 95% CI = 0. 62 ～ 1.61 ） and nausea and vomiting （ OR = 0. 77, 95% CI = 0.43 ～ 1.38） were similar in the endos-tar combination with platinum complexes group compared to those in the platinum complexes alone group. Conclusions In the treatment of ma/ignant pleural effusion, injecting endostar in combination with platinum complexes into pleural cavity improves the effective rate without obviously raised side effects. Owing to the small sample size and poor quality of included trials, more well-designed double-blinded randomized controlled trials should be performed.
出处
《中国医师杂志》
CAS
2017年第2期257-262,共6页
Journal of Chinese Physician
