莫西沙星与左氧氟沙星治疗慢性阻塞性肺疾病急性加重期疗效及安全性比较的系统评价.PDFVIP

Review Articles Chin J Evid-based Med 2012, 12(6): 694-699 莫西沙星与左氧氟沙星治疗慢性阻塞性肺疾病 急性加重期疗效及安全性比较的系统评价 王小虎  刘晓菊* 兰州大学第一医院老年呼吸科（兰州 730000 ） 摘要  目的 系统评价莫西沙星与左氧氟沙星比较治疗慢性阻塞性肺疾病急性加重期（AECOPD ）的疗效和 安全性。方法 计算机检索PubMed、EMbase 、the Cochrane Library 、CBM、CNKI 和VIP 数据库，并手工检索相关 会议论文集，纳入比较莫西沙星和左氧氟沙星治疗AECOPD 的随机对照试验（RCT ）。检索时限均从建库至2011 年7 月。按照纳入与排除标准选择文献、提取资料及评价质量后，采用RevMan5.0 软件进行Meta 分析。结果 共 纳入6 个RCT ，482 例患者。Meta 分析结果显示：莫西沙星治疗AECOPD 的临床有效率要显著高于左氧氟沙星 ［OR=3.15 ，95%CI （1.80，5.49 ），P0.000 1 ］；莫西沙星治疗AECOPD 的细菌清除率也要高于左氧氟沙星［OR=2.79 ， 95%CI （1.30，5.97 ），P=0.008 ］；而在药物不良反应方面，莫西沙星要少于左氧氟沙星［OR=0.48 ，95%CI （0.24 ，0.98 ）， P=0.04 ］。结论 目前的研究提示，莫西沙星治疗AECOPD 的临床有效率及细菌清除率均优于左氧氟沙星，且不良 反应较少。因此，当AECOPD 患者病情需要使用抗生素时，可以考虑选用莫西沙星替代左氧氟沙星进行治疗。受 纳入研究数量及质量限制，本系统评价结果尚需更多高质量、大样本、多中心随机对照试验验证。 关键词 慢性阻塞性肺疾病急性加重期；莫西沙星；左氧氟沙星；随机对照试验；Meta 分析；系统评价 Moxifloxacin versus Levofloxacin for Acute Exacerbation of Chronic Obstructive Pulmonary Diseases: A Systematic Review WANG Xiao-hu, LIU Xiao-ju* Department of Geriatric Respiratory, the First Hospital of Lanzhou University, Lanzhou 730000, China Abstract Objective To assess the effectiveness and safety of moxifloxacin versus levofloxacin for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Such databases as PubMed, EMbase, The Cochrane Library, CBM, CNKI and VIP were electronically searched, and the relevant conference proceedings were also hand-searched. The search time was up to July, 2011. Randomized controlled trials (RCTs) on moxifloxacin versus levofloxacin for AECOPD were included. Literature was screened according to inclusive and exclusive criteria, data were extracted, quality was assessed, and then meta-analysis was performed using RevMan 5.0. Results A total of 6 RCTs involving 482 patients with AECOPD were included. The results of meta-analysis showed that moxifloxacin group was significan