拉米夫定联合胸腺肽α1治疗HBeAg阳性慢性乙型肝炎患者疗效的Meta分析

齐有涛; 左维泽

doi:10.3969/j.issn.1001-5256.2014.07.016

拉米夫定联合胸腺肽α1治疗HBeAg阳性慢性乙型肝炎患者疗效的Meta分析

DOI: 10.3969/j.issn.1001-5256.2014.07.016

1. 石河子大学医学院
2. 石河子大学医学院第一附属医院感染性疾病科

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中图分类号: R512.62
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出版历程
- 收稿日期: 2013-09-13
- 出版日期: 2014-07-20

Efficacy of lamivudine and thymosin alpha-1 combination therapy in treatment of HBeAg-positive chronic hepatitis B: a meta-analysis

Medical School of Shihezi University

摘要

摘要: 目的评价拉米夫定联合胸腺肽α1治疗e抗原阳性慢性乙型肝炎患者的疗效。方法电子检索Cochrane图书馆、PubMed、EMBASE、EBSCO、中国知网、万方和维普数据库。纳入拉米夫定联合胸腺肽α1治疗HBeAg阳性慢性乙型肝炎患者停药后随访时间至少24周的临床随机对照试验。采用RevMan 5.2软件进行Meta分析。研究组间异质性采用卡方检验;若无统计学异质性(P>0.10,I2<50%),采用固定效应模型合并分析;反之,采用随机效应模型合并分析。结果经筛选,最终纳入9个随机对照试验,共600例患者,其中试验组320例,对照组280例。Meta分析结果显示:在随访结束时,血清ALT复常率、HBV DNA转阴率、HBeAg转阴率和HBeAg血清转换率合并比值比及其95%可信区间分别为4.84(3.28,7.16)、2.09(1.45,3.01)、5.32(3.35,8.46)和6.22(3.78,10.25),试验组均高于对照组,差异均有统计学意义(P<0.01)。结论拉米夫定联合胸腺肽α1治疗HBeAg阳性慢性乙型肝炎患者有较为持久的疗效,但限于纳入研究的质量和患...
- 肝炎,乙型,慢性 /
- 拉米夫定 /
- 胸腺素 /
- Meta分析
Abstract: Objective To evaluate the efficacy of lamivudine and thymosin alpha- 1 combination therapy in the treatment of HBeAg- positive chronic hepatitis B (CHB) by meta- analysis. Methods Randomized controlled trials (RCTs) of lamivudine and thymosin alpha- 1combination therapy in treatment of HBeAg- positive CHB (follow- up for at least 24 weeks) , from January 1998 to date, were identified by searching Cochrane Library, PubMed, EMBASE, EBSCO, CNKI, Wanfang Data, and CQVIP. Lamivudine monotherapy RCTs were searched for in the same way as control tests. Efficacy was measured by odds ratio. Meta- analysis was carried out with RevMan 5. 2 software. Results Nine RCTs involving 600 patients were included, with 320 cases in the combination therapy group and 280 in the control group. At the end of follow- up, the combination therapy group had significantly higher serum ALT recovery rate, HBV- DNA negative conversion rate, HBeAg negative conversion rate, and HBeAg seroconversion rate than the control group ( P < 0. 01 for all) , with pooled odds ratios (95% confidence intervals) of 4. 84 (3. 28, 7. 16) , 2. 09 (1. 45, 3. 01) , 5. 32 (3. 35, 8. 46) , and 6. 22 (3. 78, 10. 25) , respectively. Conclusion Lamivudine and thymosin alpha- 1 combination therapy is more likely to achieve sustained response rate than lamivudine monotherapy for HBeAg- positive CHB. More RCTs of high quality and large scale are required to verify this conclusion.
- hepatitis B, chronic /
- lamivudine /
- thymosin /
- Meta-analysis

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