伏立康唑治疗侵袭性真菌感染有效性及安全性的Meta分析

摘要

目的 系统评价伏立康唑治疗侵袭性真菌感染的有效性及安全性.方法 检索PubMed、Cochrane Library、EMbase、CNKI、CBM、VIP数据库,收集截至2011年12月已发表的伏立康唑治疗深部真菌感染的随机对照试验.由2名研究者按照纳入标准独立筛选文献、提取资料和评价质量后,采取RevMan 5.0软件进行Meta分析.结果 共纳入研究7项,676例.Meta分析结果提示,伏立康唑、两性霉素B的治疗成功率比较,差异无统计学意义;伏立康唑、伊曲康唑的治疗成功率、不良反应发生率比较,差异均无统计学意义;伏立康唑治疗成功率略高于米卡芬净组(P=0.11),但差异无统计学意义,其不良反应发生率高于米卡芬净(P=0.000 6).结论 伏立康唑在治疗侵袭性真菌感染中表现出高效低毒的特点.随着其临床应用愈加广泛,其价值有待进一步检验.%Objective To evaluate the effect and safety of voriconazole on invasive fungal infection systemi-cally. Methods The randomized controlled trials of voriconazole treatment for deep fungal infection( up to December 2011 )were searched from PubMed, Cochrane Library, EMbase, CNKI, CBM, VIP database. Two reviewers independently assessed the quality of the included studies and extracted the data. The RevMan 5. 0 software was used. Results A total of 7 researches ( n = 676 ) were included. Meta analysis results: there was no significant difference in successful rate between voriconazole and amphotericin B( P > 0. 05 ); no significant difference was observed in successful rate and ADR rate between voriconazole and itraconazole( P > 0. 05 ); There was no significant difference in successful rate between voriconazole and itraconazole( P = 0. 49 ), but significant difference was found between voriconazole and micaf-ungin in ADR rate( P =0. 000 6 ). Conclusion The voriconazole treatment for invasive fungal infection has high-efficiency and low-toxin. The value of voriconazole should be evaluated further with the widespread clinical use.