莫西沙星与左氧氟沙星治疗耐多药结核病有效性及安全性Meta分析
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科技部科技重大专项“重大新药创制” (2011ZX09302-003-02);江苏省科技重大专项(BM2011017)


Efficacy and safety of moxifloxacin and levofloxacin in the treatment of multidrug resistance tuberculosis:a meta-analysis
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    目的:评价国内莫西沙星与左氧氟沙星治疗耐多药结核病的疗效及安全性-方法:计算机检索中国生物医学文献数据库-中国期刊全文数据库-万方数据库及维普中文科技期刊全文数据库,收集2000年1月~2014年6月莫西沙星与左氧氟沙星治疗耐多药结核病的随机对照试验(RCT)文献,对纳入研究进行方法学质量评价,并采用RevMan 5.3.0软件进行Meta分析-结果:共纳入36个RCT-Meta分析结果显示,莫西沙星组与左氧氟沙星组相比,莫西沙星可提高服药后3个月痰菌转阴率(OR=2.25,95%CI:1.87~2.70)-疗程结束时痰菌转阴率(OR=3.70,95%CI:2.97~4.62)-病灶吸收率(OR=2.45,95%CI:1.90~3.17)-空洞闭合率(OR=1.82,95%CI:1.45~2.29)以及临床总有效率(OR=5.08,95%CI:3.58~7.22)-两组不良反应发生率差异无统计学意义(P=0.14)-结论:目前国内证据表明,莫西沙星可有效治疗耐多药结核病,其疗效优于左氧氟沙星,不良反应发生率与其相当-

    Abstract:

    Objective:To evaluate the efficacy and safety of moxifloxacin as well as levofloxacin in the treatment of multidrug resistance tuberculosis (MDR-TB) in China. Methods:Databases included the CB1Mdisc,CNKI,wangfang data,and VIP from Jan,2000 to Jun,2014 were retrospectively searched to collect randomized controlled trials (RCTs) of moxifloxacin and levofloxacin for MDR-TB. The methodological quality of included studies was evaluated,and data analyses were performed with The Cochrane Collaboration’s software RevMan 5.3.0. Results:A total of 36 RCTs were included. The results showed that,compared with the levofloxacin group,moxifloxacin increased the sputum negative conversion rate after 3-month taking(OR=2.25,95%CI:1.87~2.40)and at the end of the treatment period(OR=3.70,95%CI:2.97~4.62). Moxifloxacin was more effective in focus absorption(OR=2.45,95%CI:1.90~3.17),cavity closure(OR=1.82,95%CI:1.45~2.29)and clinical curative effect(OR=5.08,95%CI:3.58~7.22). However,there was no statistical difference in incidence of adverse reaction (P=0.14). Conclusion:According to the domestic evidence,moxifloxacin is more effective for MDR-TB than levofloxacin. Its adverse reaction rate is equivalent to levofloxacin.

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沈 昊,谢利军.莫西沙星与左氧氟沙星治疗耐多药结核病有效性及安全性Meta分析[J].南京医科大学学报(自然科学版),2014,(12):1800-1807

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  • 收稿日期:2014-07-21
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  • 在线发布日期: 2014-12-26
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