预防肾病综合征感染的循证医学证据

目的：运用循证医学原理评价目前预防肾病综合征感染的各种干预措施的有效性及安全性，为临床循证实践提供依据。方法：检索Cochrane临床对照试验数据库、MEDLINE、EMBASE和中国生物医学献数据库。结果：共检索出符合纳入标准的献11篇，包括RCT、描述性临床研究、传统综述，未检出系统评价或Meta分析献。所获献中，预防肾病综合征感染的措施涉及静脉滴注丙种球蛋白(IgG)、静脉应用胸腺肽、中药辅助治疗、肺炎链球菌疫苗接种的献，预防性应用抗生素或阿昔洛韦，以及口服拉米夫定。结论：目前，评价预防肾病综合征感染的措施的有效性及安全性的循证医学证据非常有限，研究质量较差。各种预防肾病综合征感染的措施的潜在疗效及安全性尚有待严格设计的随机双盲安慰剂对照试验或系统评价加以证实。

Evidence of Preventing Infections in Nephrotic Syndrome

Objective To review the efficacy and safety of interventions for preventing infections in nephrotic syndrome using evidence-based principles for clinicians to practice easily. Methods We searchedCochrane controlled trials register database, MEDLINE, EMBASE and Chinese Biologic Medical database. ResultsTotal 11 articles were obtained including RCTs, non-controlled clinical studies and traditional narrative reviews. No systematic review or meta-analysis was identified. Prophylactic interventions for reducing risks of infection in nephrotic syndrome included intravenous immunoglobulin, thymosin, traditional Chinese herb, lamivudine, pneumococcal vaccination and chemoprophylaxis. Conclusion At present, the studies about interventions for preventing infection in nephrotic syndrome were limited in quantity and poor in the quality of methodology, therefore, the promising conclusions were unavailable. Rigid randomized placebo-controlled clinical trials with blinding or systematic review or meta-analysis would be very necessary for further assessing the efficacy and safety of the prophylactic interventions for preventing infections in nephrotic syndrome