伊曲康唑预防艾滋病患者真菌感染有效性的Meta分析

中国真菌学杂志　 2013, Vol. 8 　Issue (6): 352-357.

伊曲康唑预防艾滋病患者真菌感染有效性的Meta分析

杨小艺¹, 蒋俊俊¹, 叶力¹, 黄颉刚¹, 周波¹, 梁冰玉¹, 陶人川², 曹存巍², 邵一鸣³, 梁浩¹

1. 广西艾滋病防治研究重点实验室广西医科大学公共卫生学院, 南宁 530021;
2. 广西艾滋病防治研究重点实验室, 南宁 530021;
3. 中国疾病预防控制中心性病艾滋病预防控制中心病毒与免疫室, 北京 102206

收稿日期:2013-09-03 出版日期:2013-12-28 发布日期:2013-12-28
通讯作者: 梁浩，E-mail：haolphd@163.com E-mail:haolphd@163.com
作者简介:杨小艺，女（汉族），硕士研究生在读.E-mail：yxyyfyx@163.com；蒋俊俊，男（汉族），硕士，实习研究员.E-mail：johnjeang@qq.com
基金资助:
“十二五”国家科技重大专项课题（2012ZX10004910），教育部博导类课题（20114503110003）

Effectiveness of itraconazole in the prophylaxis of fungal infections in AIDS patiens：a meta-analysis of randomized controlled trials

YANG Xiao-yi¹, JIANG Jun-jun¹, YE Li¹, HUANG Jie-gang¹, ZHOU Bo¹, LIANG Bing-yu¹, TAO Ren-chuan², CAO Cun-wei², SHAO Yi-ming³, LIANG Hao¹

1. Guangxi Key Laboratory of AIDS Prevention and Treatment & School of Public Health, Guangxi Medical University, Nanning 530021;
2. Guangxi Key Laboratory of AIDS Prevention and Treatment, Nanning 530021;
3. Laboratory of virus and immunology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206

Received:2013-09-03 Online:2013-12-28 Published:2013-12-28

摘要/Abstract

摘要： 目的对艾滋病患者预防性应用伊曲康唑的有效性进行Meta分析，为临床合理使用伊曲康唑预防艾滋病患者真菌感染提供依据。方法制定检索策略，检索Cochrane图书馆临床对照试验数据库、PubMed、EMbase、EBSCO、万方和清华同方数据库，时间从1981年1月~2013年7月，收集有关对艾滋病患者预防性应用伊曲康唑的随机对照临床研究。应用Stata 10.0软件进行Meta分析，采用异质性检验（齐性检验），统计合并效应量，得出合并后的RR值及其95%CI值。结果共3篇文献符合纳入标准进入Meta分析。结果显示，预防性应用伊曲康唑可以明显降低艾滋病患者的总体真菌感染率，RR=0.54（95%CI：0.44~0.67），P<0.05；而侵袭性真菌感染率差异无统计学意义，RR=0.38（95%CI：0.13~1.10），P>0.05；病死率差异无统计学意义，RR=1.14（95%CI：0.79~1.65），P >0.05。结论艾滋病患者预防性应用伊曲康唑可以明显降低总体真菌感染率，目前对侵袭性真菌感染并未显示有预防效果。对于艾滋病患者是否预防性应用伊曲康唑，需要仔细评估，要根据不同疾病阶段的真菌感染率制定不同的预防策略。

关键词: 伊曲康唑, 艾滋病, 真菌感染, Meta分析

Abstract: Objective To evaluate the effectiveness of itraconazole in the prophylaxis of fungal infections in AIDS patiens.Methods A computerized literature searching had been carried out in Cochrane Database of Clinical Controlled Trials, PubMed, EMbase, EBSCO, Wanfang and Tsinghua Tongfang database, from January 1981 to July 2013. All randomized controlled trial (RCT) papers about prophylactic use of itraconazole to prevent fungal infections in AIDS patiens were enrolled. Meta-analysis was conducted using Stata 10.0 to calculate the pooled RR value (95%CI). Consistency test was performed.Results Finally 3 pieces of RCT papers were enrolled. It showed that prophylactic use of itraconazole can significantly reduce the rate of fungal infections in AIDS patients, with the pooled relative risk (RR) and 95% confidence interval (CI) was 0.54 (95%CI:0.44~0.67),P<0.05. However it showed no statistically significant differences in the rate of invasive fungal infections, with the pooled relative risk (RR) and 95% confidence interval (CI) was 0.38 (95%CI:0.13~1.10),P >0.05. There was no statistically significant differences in case fatality rate, with the pooled relative risk (RR) and 95% confidence interval (CI) was 1.14 (95%CI:0.79~1.65),P >0.05.Conclusion Prophylactic use of itraconazole in AIDS patients can significantly reduce the overall rate of fungal infections, but for invasive fungal infections has not been shown. Whether AIDS patients should use itraconazole to prevent fungal infections, it needs to be assessed carefully, and generate different prevention strategies according to the rates of different disease stages.

Key words: itraconazole, Acquired Immune Deficiency Syndrome, fungal infections, Meta-analysis

中图分类号:

R379
R512.91

杨小艺, 蒋俊俊, 叶力, 黄颉刚, 周波, 梁冰玉, 陶人川, 曹存巍, 邵一鸣, 梁浩. 伊曲康唑预防艾滋病患者真菌感染有效性的Meta分析[J]. 中国真菌学杂志, 2013, 8(6): 352-357.

YANG Xiao-yi, JIANG Jun-jun, YE Li, HUANG Jie-gang, ZHOU Bo, LIANG Bing-yu, TAO Ren-chuan, CAO Cun-wei, SHAO Yi-ming, LIANG Hao. Effectiveness of itraconazole in the prophylaxis of fungal infections in AIDS patiens：a meta-analysis of randomized controlled trials[J]. Chinese Journal of Mycology, 2013, 8(6): 352-357.

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