目的：评价贝伐珠单克隆抗体（贝伐珠单抗）联合化疗在Her2阴性乳腺癌患者新辅助治疗中的有效性和安全性。方法：检索 PubMed、 the Cochrane Library、Web of Science、中国期刊全文数据库、万方医药期刊全文数据库和近5年重要国际肿...目的：评价贝伐珠单克隆抗体（贝伐珠单抗）联合化疗在Her2阴性乳腺癌患者新辅助治疗中的有效性和安全性。方法：检索 PubMed、 the Cochrane Library、Web of Science、中国期刊全文数据库、万方医药期刊全文数据库和近5年重要国际肿瘤学会议摘要，严格按照纳入与排除标准收集Her2阴性乳腺癌患者使用新辅助化疗联合贝伐珠单抗（联合组）对比单用新辅助化疗（化疗组）的有效性和安全性的前瞻性随机对照研究。按Cochrane系统评价方法进行质量评价，资料提取后运用RevMan 5.3软件进行meta分析。结果：最终纳入六项随机对照临床试验，共4440例患者符合条件。 Meta分析结果显示，联合组较化疗组病理完全缓解率有所提高（24.7％与20.1％，RR＝1.23，95％CI：1.10～1.37，P＜0.01）；联合组无论激素受体是否阳性均可提高病理完全缓解率（激素受体阳性亚组：13.1％与10.2％，RR＝1.28，95％CI：1.04～1.58，P＜0.05；激素受体阴性亚组：46.3％与37.1％，RR＝1.25，95％CI：1.12～1.39，P＜0.01）；联合组高血压（3.2％与0.6％， RR＝5.292，95％CI：2.933～9.549，P ＜0.01）、黏膜炎（10.5％与2.0％，RR ＝5.340，95％CI：3.743～7.617，P＜0.01）的发生率更高，其他不良反应如中性粒细胞减少性发热、感染、手术并发症、中性粒细胞减少、手足综合征联合组的发生率均高于化疗组（均P＜0.05），而周围神经病变发生率两组间差异并无统计学意义（ P＞0.05）。结论：在Her2阴性乳腺癌患者的新辅助治疗中，不论患者激素受体阳性与否，采用新辅助化疗联合贝伐珠单抗靶向治疗效果较好，但一些不良反应发生率也相应增加，需要更多的临床研究来筛选出优势人群。展开更多
Objective Both decreased glomemlar filtration rate （GFR） and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness...Objective Both decreased glomemlar filtration rate （GFR） and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women. Methods In this cross-sectional study, we randomly recruited 1131 adult women residents with GFR 〉 60 mL/min per 1.73 m2 estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity （PWVcf） and carotid-radial PWV （PWVcr） using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes （AIx-75） was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties. Results The mean estimated GFR （eGFR） of the study group was 100.05 ＋ 23.26 mL/minute per 1.73 m2. Subjects were grouped by tertiles of eGFR level. PWVef and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AJx-75. Conclusions In Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population.展开更多
文摘Objective Both decreased glomemlar filtration rate （GFR） and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women. Methods In this cross-sectional study, we randomly recruited 1131 adult women residents with GFR 〉 60 mL/min per 1.73 m2 estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity （PWVcf） and carotid-radial PWV （PWVcr） using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes （AIx-75） was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties. Results The mean estimated GFR （eGFR） of the study group was 100.05 ＋ 23.26 mL/minute per 1.73 m2. Subjects were grouped by tertiles of eGFR level. PWVef and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AJx-75. Conclusions In Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population.
