摘要
目的:运用网状Meta分析评估不同免疫吸附柱治疗类风湿关节炎的有效性与安全性,为临床诊治提供循证依据。方法:计算机检索维普、万方、中国知网、PubMed、CBM、CochraneLibrary、Web of Science等数据库,检索公开发表的免疫吸附柱治疗类风湿关节炎的研究,检索时限至2024年8月。采用Cochrane 5.4手册对纳入的随机对照试验进行质量评价,采用纽卡斯尔-渥太华量表(NOS)对回顾性队列研究进行质量评价。运用R4.1.1软件进行贝叶斯网状Meta分析。结果:最终纳入13篇研究,总样本量891例,共有4种免疫吸附柱。网状Meta分析结果表明,降低C-反应蛋白前3名排序:HA280型吸附柱+常规西药>PH-350型吸附柱+常规西药>A蛋白吸附柱;降低红细胞沉降率前3名排序:白细胞吸附柱>HA280型吸附柱+常规西药>PH-350型吸附柱+常规西药;降低关节肿胀计数前3名排序:白细胞吸附柱>A蛋白吸附柱+常规西药>PH-350型吸附柱+常规西药;降低关节压痛计数前3名排序:白细胞吸附柱>A蛋白吸附柱+常规西药>PH-350型吸附柱+常规西药;降低患者对疾病活动性评分前3名排序:PH-350型吸附柱+常规西药>白细胞吸附柱>A蛋白吸附柱;降低目测类比评分前3名排序:PH-350型吸附柱+常规西药>A蛋白吸附柱>白细胞吸附柱;降低医师对疾病活动性评分前3名排序:PH-350型吸附柱+常规西药>白细胞吸附柱>常规西药。结论:基于纳入的13篇文献证据表明,在降低C-反应蛋白方面,HA280型吸附柱联合常规西药作为首选;在降低红细胞沉降率、关节肿胀计数、关节压痛计数方面,白细胞吸附柱作为首选;在降低患者对疾病活动性评分、医师对疾病活动性评分及目测类比评分方面,PH-350型吸附柱联合常规西药作为首选,在临床中可根据患者的具体情况合理选择不同的免疫吸附柱。
OBJECTIVE:To evaluate the efficacy and safety of different immunosorbent columns in the treatment of rheumatoid arthritis through a network meta-analysis,and provide evidence-based basis for clinical diagnosis and treatment.METHODS:By computer,the databases of VIP,WanFang,CNKI,PubMed,CBM,CochraneLibrary,and Web of Science were searched for published cohort studies of immunosorbent column for the treatment of rheumatoid arthritis,with a time limit until August 2024.The quality of the included randomized controlled trials was assessed using the Cochrane5.4 manual.The quality of retrospective cohort studies were evaluated via the Newcastle-Ottawa Scale(NOS).Bayesian network meta-analysis was performed using R4.1.1 software.RESULTS:A total of 13 studies were included,with a total sample size of 891 cases,and 4 immunosorbent columns were included.The results of the network meta-analysis showed that the top three orders that reduce C-reactive protein level:HA280 adsorption column+conventional Western medicine>PH-350 adsorption column+conventional Western medicine>A protein adsorption column;the top three orders that reduce erythrocyte sedimentation rates:leukocyte adsorption column>HA280 adsorption column+conventional Western medicine>PH-350 adsorption column+conventional western medicine;the top three orders that reduce swollen joint count:leukocyte adsorption column>A protein adsorption column+conventional western medicine>PH-350 type adsorption column+conventional Western medicine;the top three orders that reduce tenderness joint counts:leukocyte adsorption column>A protein adsorption column+conventional western medicine>PH-350 adsorption column+conventional Western medicine;the top three orders that reduce patients'disease activity evaluation:PH-350 adsorption column+conventional western medicine>leukocyte adsorption column>A protein adsorption column;the top three orders that reduce visual analogue scale scores:PH-350 adsorption column+conventional Western medicine>A protein adsorption column>leukocyte adsorption column;the top three orders that reduce physician’s disease activity assessment:PH-350 adsorption column+conventional Western medicine>leukocyte adsorption column>conventional Western medicine.CONCLUSION:Based on the 13 articles,in terms of reducing C-reactive protein level,HA280 adsorption column and conventional Western medicine are the preferred choice.In terms of reducing erythrocyte sedimentation rate,swollen joint count,and tender joint count,leukocyte adsorption column is the preferred choice.In terms of reducing patient’s disease activity evaluation,physician’s disease activity evaluation and visual analogue scale scores,PH-350 adsorption column and conventional Western medicine are the first choice.Different immunosorbent columns can be reasonably and accurately selected according to the patient’s specific conditions.
作者
郑银
吴振桦
张成
阮可馨
刚骁琳
汲泓
Zheng Yin;Wu Zhenhua;Zhang Cheng;Ruan Kexin;Gang Xiaolin;Ji Hong(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning Province,China;Shengjing Hospital of China Medical University,Shenyang 117004,Liaoning Province,China)
出处
《中国组织工程研究》
北大核心
2026年第5期1260-1268,共9页
Chinese Journal of Tissue Engineering Research
基金
汲泓辽宁省名中医传承工作室(2022-1)。
作者简介
第一作者:郑银,男,1998年生,四川省南充市人,汉族,辽宁中医药大学在读硕士,主要从事风湿免疫及内科慢病方向研究,https://orcid.org/0009-0005-3465-5894;通讯作者:汲泓,硕士,主任医师,教授,博士研究生导师,中国医科大学附属盛京医院,辽宁省沈阳市117004。
