肾移植术后低剂量他克莫司免疫抑制治疗的Meta分析

目的评价肾移植术后他克莫司（TAC）低剂量对比常规剂量干预的疗效和安全性。方法检索MEDLINE、EMbase、SCI、CBM、Cochrane图书馆,纳入肾移植术后TAC低剂量对比常规剂量免疫抑制治疗的随机对照试验（RCT）。检索时间从各个数据库建库至2009年12月,对纳入研究进行方法学质量评价和Meta分析。结果纳入3个RCT,其中A级研究2个,B级研究1个。分析结果显示：两组急性排斥反应发生率比较,无统计学意义RR=1.39,95%CI（0.64,3.01）];肾小球滤过率、受者/移植物生存率和纳入分析的安全性指标差异均无统计学意义。结论基于当前临床证据,肾移植术后TAC低剂量与常规剂量干预相比,近期疗效和安全性相似;远期结果尚需进一步研究探讨。

A Meta Analysis of Low-Dose Tacrolimus Immunosuppressive Therapy in Kidney Transplant Recipients

Objective To evaluate the effect and safety of low-dose versus standard-dose tacrolimus immunosuppressive therapy on kidney transplant recipients.Methods MEDLINE,EMbase,SCI,CBM and the Cochrane library were searched and randomized controlled trials（RCT）of low-dose versus standard-dose tacrolimus immunosuppressive therapy in kidney transplant recipients were gathered.The search was updated in December 2009.Quality assessment and meta-analysis were performed.Results A total of three RCT were identified,two of which were graded A and one was graded B.The analysis results indicated that RR（95%CI）value of the acute rejection rate was 1.39（0.64,3.01）;glomerular filtration rate,patient/graft survival rate,and safety analysis were not significant different between the two groups.Conclusion Based on the evidence currently,compared to standard-dose TAC,Low-dose TAC has the same effect and safety results,but further study are needed to get the long term results.