司帕沙星对比氧氟沙星治疗耐多药肺结核的系统评价

目的系统评价司帕沙星对比氧氟沙星治疗耐多药肺结核的有效性和安全性。方法计算机检索Cochrane图书馆临床对照试验资料库（2010年第2期）和PubMed（1978年一2010年10月）、EMBASE（1974年一2010年10月）、中国学术期刊网络出版总库（1978年一2010年10月）、维普（1989年一2010年10月）、中国生物医学文献数据库（1978年一2010年10月）；手工检索其他相关杂志。检索语种为中文和英文。纳入司帕沙星对比氧氟沙星治疗耐多药肺结核的随机对照试验。按Cochrane系统评价的方法评价纳入研究质量，用RevMan5．0软件对数据进行Meta分析。结果共纳入8篇研究，Meta分析结果显示司帕沙星组与氧氟沙星组相比，痰菌转阴率、病灶显著吸收率、空洞闭合率均高于对照组，差异具有统计学意义（P〈0．05）。结论现有的证据表明，司帕沙星与其他抗结核药物联用治疗难治、耐多药肺结核的疗效优于氧氟沙星的联用方案，但由于纳入的文献数量有限，质量参差不齐，存在潜在的发表偏倚。

Systematic Review of Sparfloxacin versus Ofloxacin in Treatment of Multi-drug Resistant Pulmonary Tuberculosis

Objective To assess the clinical efficacy and safety of sparfloxacin versus ofloxacin in treatment of multi-drug resistant pulmonary tuberculosis （MDR-TB）. Methods Literatures were retrieved from PubMed （1978- October, 2010）, EMBASE （1974-October 2010）, Cochrane library （2nd volume, 2010）, China Academic Journal Network Publishing Database （1978-October, 2010）, VIP （1989-October, 2010） and CBM （1978 to October, 2010） by computer, and searched some other relevant journals manually. Chinese and English were both used in the search. Randomized controlled trials （RCTs） on sparfloxacin versus ofloxacin in treating pulmonary tuberculosis were included in this study. Meta-analysis was conducted by RevMan 5.0 software. Results The meta-analysis of 8 included RCTs showed that the sputum negative conversion rate, focus absorption rate, cavity closure rate in the sparfloxacin group were significantly higher than the ofloxacin group （P~0. 05）. Conclusions The analysis indicates that combined treatment with sparfloxacin has a better effect in treating MDR-TB than with ofloxacin. However, the reliability of this review may be affected by the number and quality of studies included. Large-scale randomized controlled trials of high quality are needed to confirm the conclusions above.