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  本文關(guān)鍵詞：重組人血小板生成素治療免疫性血小板減少癥的系統(tǒng)評價　出處：《南昌大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 重組人血小板生成素 免疫性血小板減少癥 meta分析 系統(tǒng)性評價 隨機(jī)對照試驗(yàn)

【摘要】：研究目的:系統(tǒng)性評價重組人血小板生成素(rhTPO)在免疫性血小板減少癥(ITP)治療中的療效與安全性。研究方法:計(jì)算機(jī)檢索PubMed、the Cochrane Libaray、CBM、CNKI、Wangfang Data,查找國內(nèi)外已經(jīng)發(fā)表的所有有關(guān)rhTPO治療免疫性血小板減少癥的隨機(jī)對照研究(RCT),檢索時限為建庫至2014年11月。由2名研究者根據(jù)納入和排除標(biāo)準(zhǔn)進(jìn)行文獻(xiàn)篩選、資料提取以及質(zhì)量評價,最后采用RevMan5.2軟件進(jìn)行Meta分析。研究結(jié)果:最終納入5項(xiàng)RCT試驗(yàn),共192例(初治+難治)患者。Meta分析結(jié)果顯示:rhTPO聯(lián)合糖皮質(zhì)激素組優(yōu)于激素單藥組,顯效率[OR=2.1625,95%CI(1.06,4.38),P=0.03]、有效率[OR=3.25,95%CI(1.26,8.39),P=0.01];在血小板開始上升所需的時間[WMD=-4.00,95%CI(-4.66,-3.16),P0.00001]、血小板達(dá)50x109/L所需時間[WMD=-5.25,95%CI(-6.31,-4.18),P0.00001]及血小板達(dá)峰時間[WMD=-9.99,95%CI(-15.27,-4.70),P=0.00002]方面,rhTPO聯(lián)合糖皮質(zhì)激素組優(yōu)于激素單藥組;在血糖升高[OR=0.43,95%CI(0.10,1.85),P=0.26]、血壓升高[OR=0.73,95%CI(0.18,2.97),P=0.66]方面,兩組差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:rhTPO聯(lián)合糖皮質(zhì)激素能提高ITP患者治療的顯效率及有效率,并能縮短血小板開始上升時間、血小板達(dá)50x109/L及血小板達(dá)峰所需時間;而在血糖、血壓升高方面,兩組差異無統(tǒng)計(jì)學(xué)意義。然而受納入樣本數(shù)量及質(zhì)量所限,故本系統(tǒng)性評價結(jié)論還需更多高質(zhì)量的研究進(jìn)一步證實(shí)。
[Abstract]:Objective: To study the systematic evaluation of recombinant human thrombopoietin (rhTPO) in immune thrombocytopenia (ITP) efficacy and safety in the treatment of. Research methods: PubMed, the Cochrane Libaray, CBM, CNKI and Wangfang Data were searched by computer to find all the randomized controlled trials (RCT) published at home and abroad about rhTPO for the treatment of immune thrombocytopenia. The time limit for retrieval was from November 2014 to November 2014. 2 researchers were selected according to the inclusion and exclusion criteria for literature screening, data extraction and quality evaluation. Finally, the RevMan5.2 software was used for Meta analysis. Results: in the end, 5 RCT trials were included in 192 patients (initial treatment + refractory). The results of Meta analysis showed that rhTPO combined with glucocorticoid hormone group is better than the single drug group, the significant efficiency of [OR=2.1625,95%CI (1.06,4.38), P=0.03], [OR=3.25,95%CI, P=0.01] efficiency (1.26,8.39); platelet began to rise in the time required for [WMD=-4.00,95%CI (-4.66, -3.16), P0.00001], platelet reached 50x109/L the time required for [WMD=-5.25,95%CI (-6.31, -4.18) P0.00001], peak time and platelet [WMD=-9.99,95%CI (-15.27, -4.70), P=0.00002], rhTPO combined with glucocorticoid hormone group is better than the single drug group; in elevated blood glucose (0.10,1.85), [OR= 0.43,95%CI P=0.26] [OR=0.73,95%CI (0.18,2.97), elevated blood pressure, P=0.66], no significant difference between two groups. Conclusion: rhTPO combined with glucocorticoids can improve the markedly effective rate and effective rate of ITP patients, and shorten the time of platelet start up, the time of platelet reaching 50x109/L and the time to reach the peak of platelet. However, there is no significant difference in blood glucose and blood pressure between the two groups. However, it is limited by the quantity and quality of the included samples, so the systematic evaluation conclusions need more high quality research.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R558.2

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