他克莫司与环孢素肝移植术后疗效对比的 Meta 分析.pdfVIP

·20 · 临床合理用药2015年1月第8卷第1期中 Chin J of Clinical Rational Drug Use，January2015，Vol.8 No.1B ·论 著· 他克莫司与环孢素肝移植术后疗效对比的 Meta分析 宋沧桑，张阳，李兴德，田静 【摘 要】 目的 评价肝移植术后使用免疫抑制剂他克莫司（Tac）和环孢素（CsA）的疗效差异和安全性。方法 采用中英文数据库进行文献检索，英文数据库包括 Pubmed、Medline、Embase 和 Cochrane library，中文数据库包括 CNkI、VIP、万方。纳入随机对照试验（RCT），对纳入的文献进行方法学评价和Meta分析。结果 共纳入17篇RCTs； Meta分析结果显示，Tac对比CsA，患者生存率差异无统计学意义，移植物存活率和急性排斥反应Tac优于 CsA，但他 克莫司组的糖尿病发生率较高，差异具有统计学意义。结论 肝移植术后Tac抗排斥反应治疗效果优于 CsA，但会导 致更多患者糖尿病的发生。 【关键词】 他克莫司；环孢素；肝移植；Meta分析 【中图分类号】 R 979 5 【文献标识码】 A 【文章编号】 1674＿3296（2015）01B＿0020＿04 doi 10 15887/ j cnki 13-1389/ r 2015 02 012 A Meta-Analysis of therapeutic effect of cyclosporin versus tacrolimus after liver transplantation SONG Cang-sang， ZHANG Yang，LI Xing-de，et al.Department of pharmacy，thefirstpeopleˊs Hospital of Kunming，Yunnan650011，China 【A stract】 O jective To compare the therapeutic effect difference and safety of tacrolimus and cyclosporine as pri- mary immunosuppressant for liver transplantation recipients Methods Searcheswere applied to the Database in English and Chinese English database includes Pubmed、Medline、Embase and Cochrane library；Chinese database includes CNkI、VIP、 WANGFANG；Randomized controlledtrials（RCT）comparingTacwithCsAafterlivertransplantationwereincluded Themeth- odological quality was assessed and Meta analysis，whichwereperformedwith Ravman5 2 Results Atotal of 17 RCTswere included，The results of Meta-analysis of indicated the patientsˊsurvival rate was not significantly different between tacrolimus and cyclosporine，graft survivalrateandtheincidenceof acuterejectioninTacgroupissuperiortoCsA，buttheincidencerate of diabetes in Tacgroupwas significantly higher Conclusion Comparedto cyclosporine，tacrolimus significantly reducedthe risk after liver transplantation of acute rejection，but tacrolimus increased the risk of new＿onset diabetes