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持续泵入对比间断滴注两性霉素B治疗侵袭性真菌感染疗效与安全性的Meta分析
Efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection： a meta-analysis
- 中国药房 2023年34卷第9期 页码：1115-1118
- 作者机构：
陆军军医大学第二附属医院药学部，重庆 400037
- 作者简介：
副主任药师。研究方向：临床药学、抗感染药学。 E-mail：10878953@qq.com
主任药师，博士生导师，博士。研究方向：药事管理、医院药学。电话：023-68755580。E-mail：zrcq73@163.com
- 基金信息：重庆市科卫联合医学科研项目(2021MSXM255);重庆市临床药学重点专科建设项目(渝卫办发〔2021〕52号)
DOI：10.6039/j.issn.1001-0408.2023.09.17
中图分类号： R978.5纸质出版日期：2023-05-15，
收稿日期：2023-01-19，
修回日期：2023-02-10，
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罗梦林,许汝福,胡雪莲等.持续泵入对比间断滴注两性霉素B治疗侵袭性真菌感染疗效与安全性的Meta分析 Δ[J].中国药房,2023,34(09):1115-1118.
LUO Menglin,XU Rufu,HU Xuelian,et al.Efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection： a meta-analysis[J].ZHONGGUO YAOFANG,2023,34(09):1115-1118.
罗梦林,许汝福,胡雪莲等.持续泵入对比间断滴注两性霉素B治疗侵袭性真菌感染疗效与安全性的Meta分析 Δ[J].中国药房,2023,34(09):1115-1118. DOI： 10.6039/j.issn.1001-0408.2023.09.17.
LUO Menglin,XU Rufu,HU Xuelian,et al.Efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection： a meta-analysis[J].ZHONGGUO YAOFANG,2023,34(09):1115-1118. DOI： 10.6039/j.issn.1001-0408.2023.09.17.
摘要
目的
2
比较持续泵入与间断滴注两性霉素B治疗侵袭性真菌感染的疗效与安全性，为临床治疗提供循证参考。
方法
2
计算机检索PubMed、the Cochrane Library、Web of Science、Embase、万方、中国知网、中国生物医学文献数据库、维普网，收集24 h持续泵入（试验组）对比间断滴注（对照组）两性霉素B的随机对照试验（RCT）及队列研究，检索时间均从建库起至2023年1月。筛选文献、提取资料后采用改良的Jadad量表评价RCT的质量，采用纽卡斯尔-渥太华评分量表评价队列研究的质量；采用RevMan 5.4软件进行Meta分析、敏感性分析。
结果
2
共纳入7篇文献，包括1篇RCT及6篇队列研究，共计767例患者。Meta分析结果显示，试验组患者的临床有效率[RR＝1.44，95%CI（1.13，1.83），
P
＝0.003]显著高于对照组，全因死亡率[RR＝0.37，95%CI（0.19，0.72），
P
＝0.003]、输液反应发生率[RR＝0.28，95%CI（0.18，0.43），
P
＜0.000 01]均显著低于对照组；两组患者的肾功能损害发生率比较，差异无统计学意义[RR＝0.71，95%CI（0.45，1.11），
P
＝0.13]。敏感性分析结果显示，本研究所得结果稳健。
结论
2
24 h持续泵入两性霉素B治疗侵袭性真菌感染的疗效和安全性均优于间断滴注。
Abstract
OBJECTIVE
2
To compare efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection， and to provide evidence-based reference for clinical treatment.
METHODS
2
Retrieved from PubMed， the Cochrane Library， Web of Science， Embase， Wanfang， CNKI， CBM and VIP database， randomized controlled trial （RCT） and cohort study about 24 h continuous pump （trial group） versus intermittent infusion （control group） of amphotericin B were collected from the inception to Jan. 2023. After literature screening and data extraction， the quality of RCT was evaluated with modified Jadad scale， and the quality of cohort study was evaluated with Newcastle-Ottawa scale. Meta-analysis and sensitivity analysis were performed by using RevMan 5.4 software.
RESULTS
2
A total of 7 literature were included， involving 1 RCT and 6 cohort studies with a total of 767 patients. The results of meta-analysis showed that the clinical effective rate [RR＝1.44， 95%CI（1.13，1.83），
P
＝0.003] of trial group was significantly higher than that of control group， and all-cause mortality rate [RR＝0.37，95%CI（0.19，0.72），
P
＝0.003] and the incidence rate of infusion reaction [RR＝0.28，95%CI（0.18，0.43），
P
＜0.000 01] were significantly lower than control group； there was no statistical significance in the incidence rate of renal impairment between 2 groups [RR＝0.71，95%CI（0.45，1.11），
P
＝0.13] . The sensitivity analysis results showed that the results obtained in this study were robust.
CONCLUSIONS
2
The efficacy and safety of 24 h continuous pump of amphotericin B are better than those of intermittent infusion in the treatment of invasive fungal infection.
关键词
侵袭性真菌感染两性霉素B持续泵入间断滴注疗效安全性Meta分析
Keywords
amphotericin Bcontinuous pumpintermittent infusionefficacysafetymeta-analysis
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