阿昔洛韦治疗传染性单核细胞增多症的Meta分析

目的:系统评价阿昔洛韦治疗传染性单核细胞增多症(IM)的有效性及安全性,为临床应用阿昔洛韦治疗IM提供参考依据。方法:以阿昔洛韦、IM为关键词,检索PubMed、EMbase、The Cochrane Library、VIP、CNKI和Wanfang Data,收集阿昔洛韦治疗IM的随机对照试验(RCT),检索时限均为建库至2015年8月。由两位研究者按照纳入与排除标准独立进行文献筛选、资料提取和评价纳入研究的偏倚风险后,应用RevMan5.3软件进行Meta分析。结果:共纳入6个RCT,384例患儿。Meta分析结果显示:与常规及利巴韦林治疗IM比较,阿昔洛韦可缩短患儿退热时间MD=-2.71,95% CI(-3.05,-2.36)]、咽峡炎改善时间MD=-2.66,95% CI(-3.55,-1.77)]、肿大淋巴结缩小时间MD=-3.43,95% CI(-3.90,-2.96)]及异型淋巴细胞计数减少时间MD=-3.16,95% CI(-4.25,-2.08)],差异有统计学意义。结论:阿昔洛韦可缩短IM患儿发热时间,促进咽峡炎症状改善、促进肿大淋巴结回缩及减少异型淋巴细胞计数。由于纳入文献研究质量不高,上述结论有待更多高质量研究进一步证实。

Acyclovir for Treatment of Infectious Mononucleosis: a Meta-Analysis

Objective: To systematic review the efficacy and safety of acyclovir for treatment of infectious mononucleosis (IM), and to provide evidences for improved outcomes of IM treated with acyclovir. Methods: Such databases as PubMed, EMbase, The Cochrane Library, VIP, CNKI and Wanfang Database were electronically searched to collect randomized controlled trials on acyclovir for treatment of IM from inception to August 2015. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results: Totally 6 studies were analyzed involving a total of 384 children. The results of meta-analysis showed: compared with the control group, the time of defervescence MD =-2.71, 95% CI (-3.05, -2.36)], oropharyngeal angina improvement MD =-2.66, 95% CI (-3.55, -1.77)], swollen lymphnodes shrank MD =-3.43, 95% CI (-3.90, -2.96)], and atypical lymphocyte reduced MD =-3.16, 95% CI (-4.25, -2.08)] were shorten in the acyclovir group. Conclusion: Acyclovir can reduce the duration of fever, improve oropharyngeal angina, promote swollen lymphnodes to recovery and has less time for atypical lymphocyte to fall back. Due to the limited of the included studies, the above conclusion needs to be verified by more high quality studies.