Meta分析比較抗-D免疫球蛋白與大劑量靜脈丙種球蛋白治療兒童急性特發(fā)性血小板減少性紫癜的有效性及安全性
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【摘要】：目的：比較靜脈注射抗-D免疫球蛋白(anti-D immunoglobulin,anti-D)與大劑量靜脈丙種球蛋白(IVIG)治療兒童急性特發(fā)性血小板減少性紫癜(ITP)的有效性及安全性。 方法：對anti-D治療兒童急性ITP的隨機對照試驗(與大劑量IVIG相比)進行系統(tǒng)評價和Meta分析。計算機檢索Pubmed.Embase和Cochrane Central Register of Controlled Trials.手工檢索計算機檢索出的文獻的參考文獻目錄。兩名評價者獨立完成文獻篩選、文獻質(zhì)量評價及資料提取,并作交叉核對。選取治療72h后血小板計數(shù)20×109/L的百分率和血紅蛋白下降值作為主要測量指標。采用RevMan5.1對納入文獻進行Meta分析。各研究間無異質(zhì)性時,采用固定效應模型,反之,采用隨機效應模型。 結(jié)果：共檢索到相關(guān)文獻771篇,有5篇文獻符合納入標準。治療72h后anti-D組與IVIG組血小板計數(shù)20×109/L比較：RR=0.90,95%CI：0.82-0.98,差異有統(tǒng)計學意義；亞組分析：anti-D50μg·kg-1與IVIG比較：RR=0.98,95%CI：0.84～1.13；75μ g·kg-1與IVIG比較：RR=0.88,95%CI：0.75-1.03,差異均無統(tǒng)計學意義。anti-D組血紅蛋白下降更明顯,但患者均不需要輸注懸浮紅細胞。 結(jié)論：靜脈注射anti-D治療兒童急性特發(fā)性血小板減少性紫癜的療效可能與大劑量IVIG相同�；颊邔nti-D的副作用耐受性良好。
[Abstract]:Objective: to compare the efficacy and safety of intravenous anti-D immunoglobulin (anti-D immunoglobulin,anti-D) and high dose intravenous immunoglobulin (IVIG) in the treatment of acute idiopathic thrombocytopenic purpura (ITP) in children. Methods: the randomized controlled trial (compared with high dose IVIG) of anti-D for children with acute ITP was systematically evaluated and analyzed by Meta. Computer retrieval of Pubmed.Embase and Cochrane Central Register of Controlled Trials. Manually search the bibliography of the documents retrieved by computer. Two evaluators independently completed literature screening, literature quality evaluation and data extraction, and cross-check. The percentage of platelet count 20 脳 109 / L and the decrease of hemoglobin were selected as the main indexes after 72 hours of treatment. RevMan5.1 was used to analyze the included literature by Meta. When there is no heterogeneity among the studies, the fixed effect model is used, whereas the random effect model is adopted. Results: a total of 771 articles were retrieved, 5 of which met the inclusion criteria. Platelet count 20 脳 10 9 / L in anti-D group and IVIG group 72 h after treatment: RR=0.90,95%CI:0.82-0.98, difference was statistically significant; subgroup analysis: anti-D50 渭 g kg-1 versus IVIG: RR=0.98,95%CI:0.84~1.13; Compared with IVIG, 75 渭 g kg-1 showed no significant difference in RR=0.88,95%CI:0.75-1.03,. Hemoglobin decreased significantly in anti-D group, but the patients did not need to be infused with suspended red blood cells. Conclusion: the effect of intravenous injection of anti-D on children with acute idiopathic thrombocytopenic purpura may be the same as that of high dose IVIG. Patients with anti-D have good tolerance for side effects.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R725.5
本文編號：2294824
[Abstract]:Objective: to compare the efficacy and safety of intravenous anti-D immunoglobulin (anti-D immunoglobulin,anti-D) and high dose intravenous immunoglobulin (IVIG) in the treatment of acute idiopathic thrombocytopenic purpura (ITP) in children. Methods: the randomized controlled trial (compared with high dose IVIG) of anti-D for children with acute ITP was systematically evaluated and analyzed by Meta. Computer retrieval of Pubmed.Embase and Cochrane Central Register of Controlled Trials. Manually search the bibliography of the documents retrieved by computer. Two evaluators independently completed literature screening, literature quality evaluation and data extraction, and cross-check. The percentage of platelet count 20 脳 109 / L and the decrease of hemoglobin were selected as the main indexes after 72 hours of treatment. RevMan5.1 was used to analyze the included literature by Meta. When there is no heterogeneity among the studies, the fixed effect model is used, whereas the random effect model is adopted. Results: a total of 771 articles were retrieved, 5 of which met the inclusion criteria. Platelet count 20 脳 10 9 / L in anti-D group and IVIG group 72 h after treatment: RR=0.90,95%CI:0.82-0.98, difference was statistically significant; subgroup analysis: anti-D50 渭 g kg-1 versus IVIG: RR=0.98,95%CI:0.84~1.13; Compared with IVIG, 75 渭 g kg-1 showed no significant difference in RR=0.88,95%CI:0.75-1.03,. Hemoglobin decreased significantly in anti-D group, but the patients did not need to be infused with suspended red blood cells. Conclusion: the effect of intravenous injection of anti-D on children with acute idiopathic thrombocytopenic purpura may be the same as that of high dose IVIG. Patients with anti-D have good tolerance for side effects.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R725.5
【共引文獻】
相關(guān)期刊論文 前1條
1 泥永安;劉壯;;抗-D免疫球蛋白治療兒童特發(fā)性血小板減少性紫癜研究進展[J];實用兒科臨床雜志;2012年03期
，本文編號：2294824
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