铜绿假单胞菌注射液治疗恶性胸腔积液疗效和安全性的Meta分析

Therapeutic efficacy and safety of pseudomonas aeruginosa injection in the treatment of malignant pleural effusion:a meta-analysis

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摘要目的系统评价铜绿假单胞菌注射液(PAI)胸腔灌注治疗恶性胸腔积液(MPE)的疗效和安全性。方法检索中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、维普(VIP)、万方数据库以及The Cochrane Library、PubMed、Embase、Web of Science数据库(自各数据库建库至2020年5月1日)。采用Cochrane系统评价手册推荐的方法进行质量评价,使用Review Manager 5.3软件进行统计分析。结果共纳入14项研究,共计861例病人。Meta分析显示,与对照组相比,PAI可显著提高MPE治疗总有效率[RR(95%CI):1.48(1.34~1.63)];与铂类药物组相比,PAI组总有效率也显著增高[RR(95%CI):1.53(1.37~1.71)];PAI组胸痛、发热的发生率增高,而对照组及铂类药物组的消化道反应、骨髓抑制和肝功能损害发生率更高,两组均差异有统计学意义。结论 PAI单药胸腔灌注可显著提高MPE病人的临床疗效,其主要不良反应是胸痛和发热,其他不良反应发生率低,但该结论仍需高质量、大样本的随机对照试验进一步验证。 Objective To systematically review the efficacy and safety of pseudomonas aeruginosa injection(PAI) pleural perfusion in the treatment of malignant pleural effusion(MPE).Methods We searched the China Biomedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),VIP,Wanfang,Cochrane Library,PubMed,Embase and Web of Science(from the establishment of each database to May 1,2020).The quality assessment was performed using the method recommended in the Cochrane Manual of Systematic Review,and Review Manager 5.3 software was used for statistical analysis.Results A total of 14 trials with 861 patients were included.Meta-analysis showed that PAI could significantly improve the total effective rate of MPE treatment compared with the control group [RR(95%CI):1.48(1.34-1.63)].Compared with the platinum group,the total effective rate in the PAI group was also significantly higher [RR(95%CI):1.53(1.37-1.71)].The incidence of chest pain and fever increased in the PAI group,while the incidences of gastrointestinal reactions,bone marrow suppression and liver function damage were higher in the control group and platinum drug group,and the differences between the two groups were statistically significant.Conclusions significantly improve the clinical efficacy in MPE patients.The main adverse reactions are chest pain and fever,and the incidence of other adverse reactions is low.However,this conclusion still needs to be further verified by high-quality,large-sample randomized controlled trials.

作者郑霁月孙伟孙桢李伟 ZHENG Jiyue;SUN Wei;SUN Zhen;LI Wei(Department of Oncology,Huaibei People's Hospital,Huaibei,Anhui 235000,China)

机构地区淮北市人民医院肿瘤科

出处《安徽医药》 CAS 2022年第7期1277-1281,共5页 Anhui Medical and Pharmaceutical Journal

关键词胸腔积液恶性投药局部胸腔铜绿假单胞菌注射液 META分析有效性安全性 Pleural effusion,malignant Administration,topical Pleural Pseudomonas aeruginosa injection Meta-analysis Efficacy Safety

分类号 R730.5 [医药卫生—肿瘤]

作者简介通信作者:孙伟,男,副主任医师,研究方向为肿瘤的个体化治疗,Email:876178620@qq.com。