国内静脉注射伏立康唑和氟康唑预防真菌感染临床疗效和安全性比较的Meta分析

中国真菌学杂志　 2019, Vol. 14 　Issue (3): 159-163.

国内静脉注射伏立康唑和氟康唑预防真菌感染临床疗效和安全性比较的Meta分析

刘飞飞, 王彦, 陈荣, 沈建箴

福建省血液病研究所, 福建省血液病学重点实验室, 福建医科大学附属协和医院血液内科, 福州 350001

收稿日期:2018-04-03 出版日期:2019-06-28 发布日期:2019-06-28
通讯作者: 沈建箴,E-mail:doctorsjz@163.com E-mail:doctorsjz@163.com
作者简介:刘飞飞,男(汉族),硕士研究生在读.E-mail:1915615038@qq.com
基金资助:
福建省高校产学研合作项目（2018Y004）；福建省医学创新项目（2017-CX-16）；福建省血液医学中心（2011702#）

Clinical efficacy and safety of intravenous injection voriconazole and fluconazole in preventing fungal infection in China: A meta analysis

LIU Fei-fei, WANG Yan, CHEN Rong, SHEN Jian-zhen

Department of Hematology, Fujian institute of Hematology, Fujian Provincial Key Laboratory on Hematology, The Fujian Medical Universial Union Hospital, Fuzhou 350001

Received:2018-04-03 Online:2019-06-28 Published:2019-06-28

摘要/Abstract

摘要：

目的通过Meta分析探讨静脉注射伏立康唑和静脉注射氟康唑预防真菌感染的临床疗效和安全性。方法以伏立康唑为实验组，氟康唑为对照组。通过计算机检索中国期刊全文数据库（CNKI）、万方数据库、维普数据库，并进一步对纳入文献的参考文献进行扩大检索。对符合纳入标准的随机对照研究（RCT）按Cochrane系统评价的方法，独立进行资料提取、质量评价并交叉核对后，采用Stata14.0软件进行Meta分析。结果共纳入19篇研究，共计1492例患者。伏立康唑有着更高的有效率和有更低的不良反应，两者差异有统计学意义（RR=1.20，95% CI=1.14~1.26，P<0.001）和RR=0.76，95% CI=0.65~0.90，P=0.001）。同时在控制感染发热和真菌清除方面，伏立康唑有着更好的效果，两者差异有统计学意义，分别为（RR=1.63，95% CI=1.40~1.90，P<0.001和RR=1.27，95% CI=1.13~1.44，P<0.001）。结论 Meta分析结果表明伏立康唑比氟康唑预防真菌感染有更好的疗效和预后及更低的不良反应。

关键词: 伏立康唑, 氟康唑, 真菌感染, 随机对照实验, meta分析

Abstract:

Objective To analyse the clinical efficacy and safety of intravenous injection voricanazole and intravenous injection fluconazole in preventing fungal infection by meta analysis. Method Voricanazole group was the experimental group and fluconazole group was the control group. The randomized controlled trials (RCTs) were retrieved from China National Knowledge Infrastructure (CNKI)、WanFang and VIP Database and references listed in all studies. RCTs meeting inclusive studies were included. The data was extracted, the quality was evaluated and cross-checked by two reviews independently according to Cochrane Handbook for Systematic Reviews of Interventions. Then Meta-analysis were conducted using Stata14.0 software. Results A total of 19 studies and 1492 patients were included. Voriconazole had a better effect and lower adverse events, the difference was statistically significant.(RR=1.20,95%CI=1.14-1.26,P<0.001 AND RR=0.76,95%CI=0.65-0.90,P=0.001,respectively.) Voriconazole also had statistically better effects on the control of infection fever and the clearance of fungi (RR=1.63,95%CI=1.40-1.90,P<0.001 AND RR=1.27,95%CI=1.13-1.44,P<0.001,respectively). Conclusion Meta analysis showed that voriconazole had better effect and prognosis and lower adverse events in preventing fungal infection than fluconazole. voriconazole; fluconazole; fungal infection; randomized controlled trial; meta-analysis

Key words: voriconazole, fluconazole, fungal infection, randomized controlled trial, meta-analysis

中图分类号:

R978.5

刘飞飞, 王彦, 陈荣, 沈建箴. 国内静脉注射伏立康唑和氟康唑预防真菌感染临床疗效和安全性比较的Meta分析[J]. 中国真菌学杂志, 2019, 14(3): 159-163.

LIU Fei-fei, WANG Yan, CHEN Rong, SHEN Jian-zhen. Clinical efficacy and safety of intravenous injection voriconazole and fluconazole in preventing fungal infection in China: A meta analysis[J]. Chinese Journal of Mycology, 2019, 14(3): 159-163.

参考文献

[1] 曹媛,司玉玲. 伏立康唑和氟康唑早期经验性治疗真菌感染的疗效比较[J].医学信息, 2014,27(7):203-204.
[2] 李吉明,彭鹏,李文超. 伏立康唑和氟康唑早期经验性治疗真菌感染的疗效比较[J].临床肺科杂志, 2012,17(3):439-440.
[3] 刘宏,李洋威,张剑. 伏立康唑和氟康唑早期经验性治疗ICU真菌感染的疗效比较[J].中国全科医学, 2010,13(1):106-107.
[4] 张志春. 氟康唑和伏立康唑治疗重症监护病房真菌感染患者的临床疗效[J].中国药物经济学, 2016,11(10):71-73.
[5] 沈振宇. 伏立康唑治疗老年慢性阻塞性肺疾病合并侵袭性肺部真菌感染的疗效及安全性[J].中国实用医刊, 2016,43(13):104-105.
[6] 黄耀光,林辉斌,苏伟强,等. 伏立康唑治疗肺部真菌感染的临床效果和安全性探讨[J].现代诊断与治疗, 2015,26(12):2714-2715.
[7] 连展. 伏立康唑治疗老年肺癌继发肺部真菌感染[J].药物流行病学杂志, 2010,19(9):489-491.
[8] 刘艳艳,闫飞. 氟康唑与伏立康唑治疗严重肺部真菌感染的疗效比较[J].世界最新医学信息文摘, 2016,16(59):113.
[9] 陈惠兰. 伏立康唑治疗严重肺部真菌感染临床疗效研究[J].北方药学, 2017,14(06):116-117.
[10] 黄志斌,柳晖,陈武鹏,等. 伏立康唑治疗严重烧伤患者真菌感染临床疗效分析[J].中华医院感染学杂志,2015, 25(23):5380-5382.
[11] 李建梅. 氟康唑和伏立康唑治疗肺部真菌感染的效果分析[J].世界临床医学, 2017,11(7):102-103.
[12] 欧晏娇,张雷达. 伏立康唑与氟康唑治疗肝移植术后真菌感染的疗效及安全性比较[J].现代中西医结合杂志,2017,26(9):950-952.
[13] 孙蓓,苏延军. 氟康唑与伏立康唑治疗严重肺部真菌感染的疗效比较[J].中国药房, 2013,24(24):2253-2255.
[14] 汤明. 氟康唑与伏立康唑治疗真菌感染性肺炎的疗效比较[J].西北药学杂志, 2014,29(3):283-285.
[15] 余海燕,蔡国荣, 陈进,等. 伏立康唑治疗老年重症患者侵袭性真菌感染的疗效与安全性[J].中华医院感染学杂志, 2014,24(1):102-104.
[16] 张林浩. 伏立康唑治疗肿瘤患者重症肺部真菌感染的综合评价[J].北方药学, 2016,13(2):99-100.
[17] 张晓艳,李蕾芬,张国香,等. 伏立康唑在原发性肾病综合征患者肺部真菌感染治疗中的应用效果分析[J].中华医院感染学杂志,2016,26(17):3939-3941.
[18] 赵振波. 伏立康唑治疗肺部侵袭性真菌感染的有效性与安全性分析[J].临床合理用药, 2016,9(9c):52-53
[19] 钟弢. 伏立康唑治疗ICU侵袭性真菌感染的临床分析[J].心理医生, 2015,21(14):57-58.