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-  2015 

吗替麦考酚酯诱导治疗狼疮性肾炎的Meta分析 A Meta-Analysis Efficacy Observation of Mycophenolate Mofetil for Lupus Nephritis

Keywords: 吗替麦考酚酯,环磷酰胺,狼疮性肾炎,Meta分析

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Abstract:

目的:用Meta分析方法评价吗替麦考酚酯与环磷酰胺治疗狼疮性肾炎(LN)的疗效和安全性。方法:运用万方数据库、Cochrane图书馆、PubMed和中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)检索吗替麦考酚酯治疗狼疮性肾炎的随机对照临床试验(RCTs),2014年3月25日检索文献截止,对符合标准的文献进行质量评价,用RevMan 5.1软件对符合质量标准的RCT进行Meta分析。结果:初步检索168篇相关文献中有7篇文献入选,共纳入699例患者,结果显示,实验组吗替麦考酚酯,治疗LN的总缓解率(OR=1.56,95%CI[1.13-2.14])、完全缓解率(OR=2.09,95%CI[1.08-4.05])均高于对照组环磷酰胺,且差异有统计学意义,两者部分缓解率无明显差异(OR=1.10,95%CI[0.80-1.51])。药物相关不良反应分析显示,吗替麦考酚酯组白细胞减少、月经紊乱、脱发发生率均明显低于环磷酰胺组,差异具有统计学意义。而其它不良反应如感染、胃肠道反应、带状疱疹发生率两者无明显差异。结论:吗替麦考酚酯治疗狼疮性肾炎疗效优于环磷酰胺,且药物不良反应白细胞减少、闭经、秃头发生率下降,较环磷酰胺具有更好的疗效及安全性

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