他克莫司二联与三联用药对肝移植术后患者有效性和安全性的Meta分析

目的:评价肝移植术后患者以他克莫司(FK506)不同联合用药方案的有效性和安全性。方法:计算机检索PubMed、Embase、SCI、中国期刊全文数据库(CNKI)、中国生物医学文摘数据库(CBM),同时手工检索相关专业期刊,纳入与FK506相关的随机对照试验。由2名评价者独立提取资料后进行质量评价,并采用RevMan5.0软件进行分析。结果:共纳入7个研究,包括1793名肝移植术后患者,观察终点为术后3、6、12个月。结果显示,FK506二联与三联用药方案比较,除在3个月时急性排斥反应RR=1.19,95%C(I1.02,1.38)]高于三联用药,差异具有统计学意义外,患者或移植物存活率、感染和糖尿病发生率2组间差异均无统计学意义。结论:FK506三联用药与二联用药相比可降低急性排斥反应的发生率,增加对移植肝的保护,同时不增加毒副作用。

Effectiveness and Safety of Tacrolimus Dual Regimen versu Triple Regimen for Patients after Liver Transplantation:A Meta-analysis

OBJECTIVE: To evaluate the effectiveness and safety of tacrolimus (FK506) dual regimen versus triple regimen for patients after liver transplantation. METHODS: Randomized controlled trials involving FK506 were retrieved from PubMed, Embase, SCI, CNKI, CBM. We also searched relevant journals by hand. Data were extracted and the quality of literatures were evaluated by two independent reviewers and analyzed by RevMan 5.0 software. RESULTS: A total of 7 studies were included, involving 1 793 patients. The endpoints were 3,6,12 months after transplantation. Meta-analysis showed that the rate of acute rejection RR=1.19, 95%CI (1.02,1.38)] in dual regimen group was higher than triple regimen group 3 months after transplantation, there was statistical significance. Graft or patient survival rate, infection and the incidence of diabetes had no significant different between 2 groups. CONCLUSION: Compared with dual regimen of FK506, the triple regimen can reduce the acute rejection after liver transplantation, improve the protection of liver and has no additional toxic side effects.