静脉注射免疫球蛋白与血浆置换治疗重症肌无力的meta分析

目的系统评价静脉注射免疫球蛋白(IVIg)与血浆置换(PLEX)治疗重症肌无力(MG)的有效性和安全性。方法计算机检索Cochrane图书馆、Pubmed、Embase、CNKI及万方数据库,系统收集国内外有关这两种方式治疗MG的相关文献。按系统评价的方法,由2名研究员独立对文献进行质量评价和资料提取后,采用Rev Man 5.2软件进行Meta分析。结果共纳入9篇文献,合计2132例MG患者。Meta分析结果显示,IVIG与PLEX治疗MG的有效性无明显差异[OR=0.94,95%CI(0.57,1.32),P=0.79];IVIg与PLEX的治疗相关不良反应发生率也无明显差异[OR=0.91,95%CI(-0.37,2.21),P=0.83]。结论 IVIG与PLEX对MG的治疗效果以及治疗相关的不良反应发生率均无明显差异,因此,临床上可根据具体情况选择合适的治疗方式。

Intravenous immunoglobulin and plasma exchange in treatment of myasthenia gravis: a meta-analysis

Objective To systematically evaluate the efficacy and safety of intravenous immunoglobulin (IVIg) and plasma exchange (PLEX) in the treatment of myasthenia gravis (MG).Methods Cochrane Library, PubMed, Embase, China National Knowledge Internet, and Wanfang Data were systematically searched and related articles on the two methods in the treatment of MG were selected. Quality of the literature was evaluated and data were extracted independently by two researchers in accordance with the method of systematic review. Meta-analysis was performed by use of RevMan 5.2 software.Results A total of 9 studies involving 2131 patients with MG were included. The results of meta-analysis showed that there were no significant differences in the efficacy [OR=0.94, 95% CI (0.57, 1.32), P=0.79]and treatment-related adverse effects [OR=0.91, 95% CI (-0.37, 2.21), P=0.83] between IVIg and PLEX in the treatment of MG.Conclusions The efficacy and treatment-related adverse effects show no significant differences between IVIg and PLEX in the treatment of MG. Therefore, appropriate therapeutic method should be selected according to the specific conditions.