甘露聚糖肽联合顺铂治疗恶性胸腔积液的系统评价

【】　目的　采用循证医学的方法评价甘露聚糖肽联合顺铂对比单用顺铂治疗恶性胸腔积液的有效性和安全性。　方法　计算机检索中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库、万方数据库，收集甘露聚糖肽联合顺铂对比单用顺铂治疗恶性胸腔积液的随机对照试验，检索时间为各数据库建库至2011年3月。对文献进行质量评价，用RevMan5.0软件对数据进行Meta分析。　结果　共纳入6项研究，所有文献质量均为C级。共收入388例患者，Meta分析结果显示甘露聚糖肽联合顺铂组与单用顺铂组相比，总有效率前者高于后者，差异有统计学意义（P<0.05）；消化道不良反应发生率两组组间差异无统计学意义（P=0.05）；骨髓抑制发生率前者低于后者，差异有统计学意义（P<0.05）；Karnofsky评分提高率前者高于后者，差异有统计学意义（P<0.05）。　结论　系统评价表明，甘露聚糖肽联合顺铂治疗恶性胸腔积液的疗效优于单用顺铂的方案。【Abstract】　Objective　Toassesstheclinicalefficacyandsafetyofmannatidepluscisplatintreatingmalignantpleuraleffusion.　Methods　LiteratureswereretrievedfromCBM,VIP,CNKI,Wanfangdatabasesbycomputer.Literatureswereenrolledaccordingtoinclusionandexclusioncriteria,andthequalityofstudieswasevaluatedaccordingtotheCochraneLibraryhandbook.TheperioddurationofsearchingwasbetweentheestablishmentofthedatabasesandMarch,2011.Meta-analysiswasconductedbyRevMan5.0software.　Results　Themeta-analysisof6includedRCT,allrankedC,whichinvolved388patients.TheMeta-analysisshowedthatthetotaleffectiverateinmannatidepluscisplatingroupsignificantlydifferedfromthatincisplatingroup(P＜0.05).Therewerenosignificantdifferenceintheadversereactionofdigestivetractbetweenthetwointerventiongroups(P=0.05).Theadversereactionofmarrowdepressioninmannatidepluscisplatingroupwasmuchlowerthanthatincisplatingroup(P＜0.05).TheincreaseofKPSinmannatidepluscisplatingroupwashigherthanthatincisplatingroup(P＜0.05).　Conclusions　Theanalysisindicatesmannatidepluscisplatinhasabettereffectonmalignantpleuraleffusionthansinglecisplatin.However,thereliabilityofthisreviewisaffectedbypoorqualityofincludedstudies,andlarge-scalerandomizedcontrolledtrialsofhighqualityareneededtoconfirmtheconclusionsabove.