摘要
目的系统的评价全口服直接抗病毒药物(DAA)与无DAA(NDAA)方案对于丙型肝炎相关肝细胞癌(HCC)患者在无复发生存率、HCC复发率、全因死亡率、肝脏相关病死率方面的差异。方法检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、Pubmed、Embase、Cochrane Library七大数据库于2020年12月之前公开发表的DAA治疗丙型肝炎相关HCC患者的临床队列研究,并进行质量评价与Meta分析。结果本研究共纳入10个临床队列研究,共计3108例患者。Meta分析结果显示:与NDAA方案相比,DAA治疗能够显著提高丙型肝炎相关HCC患者的无复发生存率(RR=1.38,95%CI:1.10~1.72,P=0.005),降低HCC复发率(RR=0.52,95%CI:0.42~0.63,P<0.00001)、全因死亡率(RR=0.42,95%CI:0.32~0.55,P<0.00001)及肝脏相关病死率(RR=0.37,95%CI:0.18~0.76,P=0.007)。结论对于丙型肝炎相关HCC患者使用DAA治疗是有益且安全的。
Objective To systematically evaluate the difference in recurrence-free survival rate,hepatocellular carcinoma(HCC)recurrence rate,all-cause mortality rate,and liver-related mortality rate between hepatitis C-related HCC patients receiving oral direct-acting antiviral(DAA)and those receiving non-DAA(NDAA)treatment regimen.Methods CNKI,Wanfang Data,VIP,CBM,PubMed,Embase,and Cochrane Library were searched for Cohort studies of DAA in the treatment of hepatitis C-related HCC patients published before December 2020,and quality assessment and meta-analysis were performed.Results A total of 10 cohort studies were included in this study,with 3108 patients in total.The meta-analysis showed that compared with NDAA regimen,DAA treatment significantly increased recurrence-free survival rate(risk ratio[RR]=1.38,95%confidence interval[CI]:1.10-1.72,P=0.005)and significantly reduced HCC recurrence rate(RR=0.52,95%CI:0.42-0.63,P<0.00001),all-cause mortality rate(RR=0.42,95%CI:0.32-0.55,P<0.00001),and liver-related mortality rate(RR=0.37,95%CI:0.18-0.76,P=0.007)in hepatitis C-related HCC patients.Conclusion DAA treatment is beneficial and safe for hepatitis C-related HCC patients.
作者
周荃
杨丽晖
蒋芳清
ZHOU Quan;YANG Lihui;JIANG Fangqing(The First Hospital of Changsha,Changsha 410000,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2021年第8期1836-1840,共5页
Journal of Clinical Hepatology
作者简介
通信作者:蒋芳清,478772806@qq.com。
