不同剂量钙调磷酸酶抑制剂联合依维莫司用于肾移植受者免疫抑制治疗Meta分析

摘要

Objective To evaluate the safety and efficacy of Everolimus ( ERI ) combined with different doses of Calcineurin Inhibitors ( CNI ) for renal transplantation recipients in immunosuppression. Methods The datas were searched Embase,PubMed,Science Citation Index,Cochrane Library,CNKI,Wanfang Data,Chinese Biomedical Database disc,VIP information,the randomized controlled trials ( RCTs ) based on the inclusion criteria by using different dose of CNI combined with ERI after renal transplantation,then we assessed method-ological quality,extracted data and the studies were meta-analyzed by using RevMan 5. 0 software. Results 3 RCTs were eligible. The Meta-analysis indicated that:after renal transplantation,compared with CNI high-dose group,the biopsy-proven acute rejection and mortality of CNI low-dose group were not statistically significant(P > 0. 05);glomerular filtration rate,serum creatinine levels and cre-atinine clearance rate were statistically significant(P 0. 05). Conclusion Based on the evidence,the low-dose CNI combined with ERI improved kidney function after renal transplantation.%目的 系统评价不同剂量钙调磷酸酶抑制剂(CNI)联合依维莫司(ERL)用于肾移植术后免疫抑制治疗的有效性和安全性.方法 计算机检索Cochrane图书馆、Embase、SCI、PubMed、VIP、CBM、CNKI和万方数据库,纳入肾移植术后使用不同浓度CNI联合ERL进行免疫抑制治疗的随机对照试验(RCT).在评价纳入研究的方法学质量和提取有效数据后,采用RevMan 5.0软件进行Meta分析.结果 共纳入3个RCT,对比低、高剂量CNI联用ERL发生的活检证实的急性排斥反应、患者死亡率,差异无统计学意义(P>0.05),但可达到更高的肾小球滤过率、更高的肌酐清除率和更低的血清肌酐水平,差异有统计学意义(P0.05).结论 基于当前临床证据,低剂量CNI联合ERL用于肾移植术后对肾脏有一定的保护作用.