摘要
目的:钙神经调节蛋白抑制剂(CNIs)在狼疮性肾炎(LN)治疗中的作用受到越来越多人的关注。本研究通过Meta分析评估CNIs诱导治疗LN的疗效及安全性,并与对照治疗进行比较。方法:检索Pubmed、EMBASE、Cochran图书馆及万方数据库、中国知网、维普中文科技期刊数据库,检索时间截止至2017年9月,纳入环孢素A(Cs A)和他克莫司(FK506)与吗替麦考酚酯(MMF)或环磷酰胺(CTX)相比较的随机对照临床试验。采用Stata12软件进行Meta分析。结果:共计16篇(871例患者)符合标准的文献纳入本研究。Meta分析结果显示CNIs组总有效率(P<0. 001)、完全缓解率(P<0. 001)均优于对照组。CNIs组的感染、消化道症状、白细胞减少及月经紊乱的发生率明显低于对照组。而一过性肌酐升高、血压升高及血糖升高的发生率则明显高于对照组。结论:CNIs用于LN诱导治疗药物,其疗效及安全性均优于对照组,但其长期维持治疗的疗效及安全性仍需要进一步评估。
Objective：There is growing interest in the role of calcinenrin inhibitors （CNIs） in lupus nephritis （LN） induction treatments.The study aimed to evaluate the efficacy and safety of CNIs as induction treatment for LN by recta-analysis. Methodology：PubMed,EMBASE, Cochrane Central Register of Controlled Trials （CENTRAL） , and three Chinese databases （WanFang Data, Chongqing VIP and China National Knowledge Infrastructure ） were searched for all human studies in induction treatment of LN with CNIs up to September 2017. Randomized controlled trials （ RCTs ） comparing the efficacy and safety of CNIs with other drugs in LN patients were included.Statistical analyses were performed using Statal2 software. Results： A total of sixteen studies involving 871 patients were included in this study. CNIs had significant merits in increasing total remission （P〈0. 001 ） and complete remission （P〈0. 001 ）.The incidences of infection, gastrointestinal discomfort, leukopenia and menstrual disorder were higher in control group, whereas the incidences of hypertension ,transient creatinine elevation and abnormal glucose metabolism were higher in CNIs group. Conclusion：Our systematic review demonstrates that CNIs are promising alternatives for LN patients, primarily due to their better short-term efficacy and safety.Well-designed clinical trials are needed to further evaluate the long-term efficacy and safety of CNIs.
作者
王晶晶
刘正钊
陈樱花
周敏林
章海涛
WANG Jingjing;LIU Zhengzhao;CHEN Yinghua;ZHOU Minlin;ZHANG Haitao(National Clinical Research Center of Kidney Diseases,Jinling Hospital,Nanfing University School of Medicine,Nanjing 210016,China)
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
北大核心
2018年第5期424-429,共6页
Chinese Journal of Nephrology,Dialysis & Transplantation
基金
国家科技支撑计划课题(2015BAI12B05)
国家精准医学重点研发计划项目(2016YFC0904103)
