复方磺胺甲噁唑联合卡泊芬净治疗耶氏肺孢子菌肺炎疗效与安全性的Meta分析

摘要/Abstract

摘要： 目的系统评估复方磺胺甲噁唑(TMP/SMZ)与卡泊芬净联合对耶氏肺孢子菌肺炎(Pneumocystis jirovecii pneumonia, PJP)的治疗效果和安全性。方法搜索PubMed、Embase、Cochrane library、CBM、知网、万方、维普中,TMP/SMZ联合卡泊芬净治疗PJP的临床随机对照试验,进行Meta分析,结局指标为总有效率、不良反应发生率,使用RevMan5.4软件统计分析。结果共纳入20项研究,PJP患者共1 802例。Meta分析结果显示,相较TMP/SMZ单药治疗,TMP/SMZ联合卡泊芬净治疗PJP的有效率显著提高[RR=1.29,95% CI (1.22,1.37), P<0.00001],且不增加药物不良反应发生率[RR=0.9 1,9 5% CI (0.7 9,1.0 5), P=0.2 1>0.0 5]。结论 TMP/SMZ联合卡泊芬净治疗PJP的效果优于TMP/SMZ单药治疗,且不增加药物不良反应,推荐临床使用。

关键词: 复方磺胺甲噁唑, 卡泊芬净, 耶氏肺孢子菌肺炎(PJP), Meta分析

Abstract: Objective To systematically evaluate the efficacy and safety of trimethoprim-sulfamethoxazole (TMP/SMZ) combined with caspofungin in the treatment of Pneumocystis jirovecii pneumonia (PJP). Methods PubMed, Embase, Cochrane library, CBM, CNKI, Wanfang, VIP were searched for clinical randomized controlled trials of TMP/SMZ combined with caspofungin in the treatment of PJP, and Meta-analysis was performed. The outcome indicators were total effective rate, incidence of adverse reactions Statistical analysis was performed using RevMan 5.4 software. Results A total of 20 studies were included, involving 1 802 PJP patients. Meta-analysis results showed that compared with TMP/SMZ monotherapy, the effective rate of TMP/SMZ combined with caspofungin in the treatment of PJP was significantly improved, [RR =1.29, 95% CI (1.22,1.37),P< 0.00001], and no Increase the incidence of adverse drug reactions [RR =0.91,95% CI(0.79, 1.05),P=0.21>0.05]. Conclusion The effect of TMP/SMZ combined with caspofungin in the treatment of PJP is better than that of TMP/SMZ monotherapy, without increasing adverse drug reactions, and it is recommended for clinical use.

Key words: trimethoprim-sulfamethoxazole, caspofungin, Pneumocystis jirovecii pneumonia (PJP), Meta-analysis

中图分类号:

R519

段艳, 徐媛, 杨长青, 张晋萍. 复方磺胺甲噁唑联合卡泊芬净治疗耶氏肺孢子菌肺炎疗效与安全性的Meta分析[J]. 中国真菌学杂志, 2023, 18(1): 1-7.

DUNA Yan, XU Yuan, YANG Changqing, ZHANG Jinping. Meta-analysis of trimethoprim-sulfamethoxazole combined with caspofungin in the treatment of Pneumocystis jirovecii pneumonia[J]. Chinese Journal of Mycology, 2023, 18(1): 1-7.

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