本文選題：乳頭狀瘤病毒疫苗 + 宮頸腫瘤　； 參考：《中國全科醫(yī)學》2015年12期

【摘要】：目的系統(tǒng)評價人乳頭瘤病毒(HPV)疫苗預防宮頸癌及HPV相關感染的有效性與安全性。方法計算機檢索Pub Med、EMBase、Cochrane Library、OVID、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM)、中國知網(wǎng)、萬方數(shù)據(jù)庫,并輔以手工檢索相關雜志和納入研究的參考文獻,查找關于HPV疫苗預防宮頸癌及HPV相關感染的隨機對照研究(RCT),檢索時限從建庫至2014年7月。由2名評價員按照納入和排除標準獨立進行文獻篩選、資料提取和質(zhì)量評價后,采用Rev Man 5.2軟件進行Meta分析。結果最終納入23篇RCT。Meta分析結果顯示,疫苗組宮頸上皮內(nèi)瘤樣病變(CIN)Ⅱ+發(fā)生率、6個月HPV持續(xù)性感染發(fā)生率、12個月HPV持續(xù)性感染發(fā)生率、陰道內(nèi)皮瘤樣變(VIN)Ⅱ+/外陰內(nèi)皮瘤樣變(Va IN)Ⅱ+發(fā)生率、外生殖器疣發(fā)生率、高危型HPV(HR-HPV)相關感染與疾病發(fā)生率均低于對照組(P0.05)。按照預案規(guī)定(PP)人群及意向性分析(ITT)人群,疫苗組CINⅡ+發(fā)生率、6個月HPV持續(xù)性感染發(fā)生率、12個月HPV持續(xù)性感染發(fā)生率、VINⅡ+/Va INⅡ+發(fā)生率、外生殖器疣發(fā)生率、HR-HPV相關感染與疾病發(fā)生率均低于對照組(P0.05)。疫苗組注射部位相關不良反應發(fā)生率高于對照組(P0.05);疫苗組與對照組系統(tǒng)不良反應發(fā)生率、嚴重不良反應發(fā)生率、病死率比較,差異無統(tǒng)計學意義(P0.05)。結論 HPV疫苗對預防宮頸癌前病變、HPV持續(xù)性感染、HPV相關外生殖器病變顯示了高效的保護效應和交叉保護效果,因此是安全、有效的。然而現(xiàn)有報道尚未證明HPV疫苗預防宮頸癌的遠期療效,不能提供HPV疫苗預防宮頸癌的直接證據(jù),有待開展更多高質(zhì)量RCT并延長隨訪時間以進一步驗證。
[Abstract]:Objective to evaluate the efficacy and safety of human papillomavirus (HPV) vaccine in the prevention of cervical cancer and HPV related infections. Methods Pub Medsite was searched by computer, the Chinese Biomedical Literature Database (CBM), the Chinese knowledge Network, the Wanfang Database, and the related journals and references were retrieved by hand. A randomized controlled study on the prevention of cervical cancer and HPV associated infections with HPV vaccine was conducted. The search time was from the establishment of the library to July 2014. According to the criteria of inclusion and exclusion, two evaluators independently carried out literature screening, data extraction and quality evaluation, and Meta analysis was carried out with Rev Man 5.2 software. Results the results of 23 RCT.Meta analysis showed that the incidence of cervical intraepithelial neoplasia (cin) 鈪，

本文編號：1988567