[1]蒋欣宇,李现成,程小红.环孢素A治疗特发性膜性肾病疗效和安全性系统评价Meta分析[J].陕西医学杂志,2021,50(10):1303-1308，1317.[doi:DOI:10.3969/j.issn.1000-7377.2021.10.033]
　JIANG Xinyu,LI Xiancheng,CHENG Xiaohong.Systematic review and meta-analysis of the efficacy and safety of cyclosporine A in treatment of idiopathic membranous nephropathy[J].,2021,50(10):1303-1308，1317.[doi:DOI:10.3969/j.issn.1000-7377.2021.10.033]
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环孢素A治疗特发性膜性肾病疗效和安全性系统评价Meta分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年10期
页码:
1303-1308，1317
栏目:
Meta分析
出版日期:
2021-10-05

文章信息/Info

Title:
Systematic review and meta-analysis of the efficacy and safety of cyclosporine A in treatment of idiopathic membranous nephropathy
作者:
蒋欣宇1; 李现成2; 程小红2
(1.陕西中医药大学,陕西 咸阳712046; 2.陕西省中医医院,陕西 西安710003)
Author(s):
JIANG Xinyu; LI Xiancheng; CHENG Xiaohong
(Shaanxi University of Chinese Medicine,Xianyang 712046,China)
关键词:
特发性膜性肾病;  环孢菌素;  糖皮质激素;  系统评价;  Meta分析;  安全性
Keywords:
Idiopathic membranous nephropathy;  Cyclosporine;  Glucocorticoid;  System assessment;  Meta analysis;  Safety
分类号:
R 692
DOI:
DOI:10.3969/j.issn.1000-7377.2021.10.033
文献标志码:
A
摘要:
目的:系统评价环孢素A(CsA)治疗特发性膜性肾病(IMN)的临床疗效与安全性。方法:计算机检索中国知网(CNKI),万方(WanFang),维普(VIP),中国生物医学文献数据库(Sino Med),Pub Med,EMbase,The cochrane library这7个数据库建库至2020年12月的数据。由2名人员单独挑选文献、提取数据资料,应用Rev Man5.4.1进行制作风险评估图和Meta分析和R语言4.0.3进行发表偏倚评估。结果:共纳入文献13个,共825例患者,试验组414例,对照组411例,两组相比,12个月RR(OR=2.40,95%CI:1.64～3.51,P<0.00001)、12个月CR(OR=1.93,95%CI:1.36～2.76,P=0.0003)、不良反应发生率(OR=0.31,95%CI:0.21～0.45,P<0.00001)、血肌酐值(MD=1.31,95%CI:-0.34～2.96,P=0.12)、血清总胆固醇(SMD=-1.21,95%CI:-1.39～-1.03,P<0.00001)、24 h尿蛋白定量(SMD=-1.16,95%CI:-1.93～-0.39,P=0.003)、血清白蛋白(MD=6.76,95%CI:6.24～7.28,P<0.00001)。分析结果显示环孢素A组在治疗IMN的完全缓解率和总缓解率、不良反应发生率、降低血清胆固醇、提升血清白蛋白水平优于对照组,而在降低血肌酐方面无统计学差异(均P>0.05)。结论:相比于传统治疗环磷酰胺,环孢素A在治疗IMN缓解率上、降低尿蛋白、提升血清白蛋白水平、降脂具有一定的优势,由于大部分文献质量较低,会对结果造成一定的影响。
Abstract:
Objective:To systematically evaluate the clinical efficacy and safety of cyclosporine A(CsA)in the treatment of idiopathic membranous nephropathy.Methods:The data from CNKI,Wanfang,VIP,CBM,PubMed,Embase and The Cochrane Library were retrieved by computer until December 2020.Rev Man 5.4.1 was used to make risk assessment chart and meta analysis,and R 4.0.3 was used to evaluate publication bias.Results:A total of 13 studies were included,with a total of 825 patients,414 in the experimental group and 411 in the control group.Compared with the control group,12-month RR(OR=2.40,95%CI:1.64 to 3.51,P<0.00001)and CR(OR=1.93,95%CI:1.36 to 2.76,P=0.0003),the incidence of adverse reactions(OR=0.31,95%CI:0.21 to 0.45,P<0.00001),serum creatinine value(MD=1.31,95%CI:-0.34 to 2.96,P=0.12),serum total cholesterol(SMD=-1.21,95%CI:-1.39 to -1.03,P<0.00001),24-hour urine protein level(SMD=-1.16,95%CI:-1.93 to -0.39,P=0.003),serum albumin(MD=6.76,95%CI:6.24 to 7.28,P<0.00001).The analysis results showed that the complete response rate and total response rate,the incidence of adverse reactions,the reduction of serum cholesterol and the increase of serum albumin in the cyclosporine group were better than the control group in the treatment of IMN,while there was no significant difference in the reduction of serum creatinine.Conclusion:Compared with the traditional treatment of cyclophosphamide,cyclospore A has certain advantages in treating remission rate of IMN,reducing urinary protein,increasing serum albumin and lowering lipid.However,since most of the literature is of low quality,it will have a certain impact on the results.

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备注/Memo

备注/Memo:
基金项目:国家重点研发计划项目课题(2019YFC1709404)
更新日期/Last Update: 2021-10-08