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华西医学  2011 

干扰素治疗蕈样霉菌病的系统评价

, PP. 551-555

Keywords: 干扰素,蕈样霉菌病,淋巴瘤,T细胞,对照试验,系统评价

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Abstract:

【】 目的 采用系统评价方法,评估干扰素(IFN)治疗蕈样霉菌病(MF)的疗效及安全性。 方法 计算机检索截止2010年5月的Cochrane协作网系统评价方法,纳入所有比较IFN与其他方法治疗MF的随机对照试验及临床对照试验进行质量评价,采用RevMan5.0.24软件进行Meta分析。 结果 共纳入6篇符合标准的已发表文献,包括142例受试者。Meta分析结果显示IFN-α单独使用对MF的疗效优于安慰剂组OR=69.36,95%CI(3.71~1296.64)及地精丹方剂OR=35.53,95%CI(1.78~710.56);而IFN-α与胸腺肽OR=15.11,95%CI(0.71~322.61)及IFN-α+阿维A酯OR=3.10,95%CI(0.79~12.12)的临床疗效差异无统计学意义;IFN-γ联合窄谱中波紫外线(NB-UVB)治疗与单用NB-UVB的临床疗效差异无统计学意义OR=15.00,95%CI(0.46~485.32)。90%的患者出现轻度“流感样症状”的不良反应,多可缓解及消退。 结论 IFN是目前治疗MF的一线用药,疗效确切且大部分患者耐受性较好。【Abstract】 Objective Toevaluatetheclinicalefficacyandsideeffectsofinterferon(IFN)inthetreatmentofmycosisfungoides(MF)withthemethodofsystematicreview. Methods AccordingtotheCochranereviewer’shandbook,alltheclinicalcontrolledtrialsinvolvingmycosisfungoidesbeingtreatedwithinterferonwereretrieved.TheCochraneCollaboration’ssoftwareRevMan5.0.24wasusedformeta-analysis. Results Onlysixpapersincluding142patientsmettheinclusioncriteria.Meta-analysesindicatedtheresultsasfollowsIFN-αmonotherapywasmoreeffectivethanplaceboOR=69.36,95%CI(3.71-1296.64)andatraditionalChinesemedicine(Di-jing-dan)OR=35.53,95%CI(1.78-710.56),butnosignificantdifferencewasfoundbetweenINF-αandthymicpeptideOR=15.11,95%CI(0.71-322.61),andbetweenIFN-αmonotherapyandIFN-αcombinedwithetretinatetherapyOR=3.10,95%CI(0.79-12.12);andtherewasnosignificantdifferencebetweentheefficacyofIFN-γcombinednarrowbandultravioletB(NB-UVB)therapyandthatofsingleNB-UVBtherapyOR=15.00,95%CI(0.46-485.32);Influenza-likesideeffectsoccurredto90%ofallthepatients,whichwereusuallyslightandeasytorelease. Conclusion Althoughtherearesomemildsideeffects,interferonissafetotreatMF.

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