000000ce_蔡和平-医院药学..doc

两种含地塞米松的预处理方案对紫杉醇过敏反应预防效果的Meta分析 蔡和平，张铃铃，杨 黎，王 卓*，周 佳，高 申（第二军医大学长海医院 200433） 【摘要】目的：用Meta分析的方法对国外已发表的高质量的有关比较两种含地塞米松的预处理方案预防紫杉醇过敏反应效果的临床研究进行综合定量分析，为临床医生在选择预防方案时提供参考依据。方法：收集PubMed建库～2010年5月27日发表的有关比较两种含地塞米松的预处理方案对紫杉醇过敏性反应预防效果的文献，根据Meta分析的要求对检索到的原始文献进行质量评估，对符合要求的所有文献研究结果进行Meta分析，评估两种不同预处理方案降低过敏反应和严重过敏反应发生率的优势比（OR），评价两组方案对患者过敏反应发生率的影响。结果：符合纳入标准的共有4篇文献，总样本量为666例，其中在紫杉醇用药前两次（12 h和6 h）口服地塞米松组368例，发生过敏反应65例，严重过敏反应8例；在紫杉醇用药前一次（30 min ）静脉注射地塞米松组298例，发生过敏反应70例，严重过敏反应20例；所有过敏反应发生率的合并OR=0.69，95%可信区间分别为（0.46-1.02）；严重过敏反应发生率的合并OR=0.32，95%可信区间分别为（0.14-0.75）；结论：口服地塞米松组预防紫杉醇过敏反应的发生率与静脉注射地塞米松组预防紫杉醇过敏反应的发生率无统计学意义。但口服地塞米松组预防紫杉醇严重过敏反应的发生率比静脉注射地塞米松组预防紫杉醇严重过敏反应的发生率低0.68，有统计学意义。 关键词 紫杉醇 地塞米松 过敏反应 meta分析 Meta-analysis of therapeutic effect of two regimens contain dexamethasone to prevente paclitaxel’s hypersensitivity CAI He-ping，ZHANG Ling-ling，WANG Zhuo*，YANG Li，ZHOU Jia，GAO Shen ( Department of Pharmacy，Changai Hospital , Second Military Medical University, Shanghai 200433，China ) [Abstract] Objective：Search all studies that have been published in foreign country with regard to two regimens contain dexamethasone of preventing paclitaxel’s hypersensitivity and analysis them which are in high quality by means of meta-analysis, in order to give evidences when selecting regimens. Method: Evaluate strictly all the studies that have been searched in PubMed from setup data base to 2010.05.27 and adopt the studies with regard to two regimens contain dexamethasone of preventing paclitaxel’s hypersensitivity by means of meta-analysis. calcute the odds radio(OR) for incidence of hypersensitivity reaction and serious hypersensitivity reaction of two regimens. RevMan 4.2 software was applied to process date. Result: Totally 4 studies including 666 cases were analyzd. The cumulative cases in two doses of oral dexamethasone,12 and 6h prior to paclitaxel group were 368,in which 65 cases were occurrence hypersensitivity, 8 cases were occurrence serious hypersensitivity; while in singl