比较环孢菌素与英夫利息单抗治疗重症难治性溃疡性结肠炎疗效的荟萃分析

目的比较环孢菌素与英夫利息单抗治疗重症难治性溃疡性结肠炎后结肠切除率及并发症发生率。方法检索PubMed、EMBASE、Cochrane Library数据库中所有关于比较环孢菌素与英夫利息单抗治疗重症难治性溃疡性结肠炎的研究。应用比值比(OR)及其95%CI为疗效分析统计量。用Review Manager 5.1软件对符合纳入标准的研究通过固定效应模式或随机效应模式进行荟萃分析,比较使用环孢菌素和英夫利息单抗后的3个月、12个月的结肠切除率及并发症的发生率。结果共9篇文献纳入荟萃分析。其中,6篇为回顾性研究,2篇为前瞻性研究,1篇为多中心随机对照研究。对于3个月的结肠切除率,OR值为1.48(95%CI:0.61~3.62,P=0.39);对于12个月的结肠切除率,OR值为1.36(95%CI:0.59~3.12,P=0.47);对于并发症的发生率,OR值为0.88(95%CI:0.54~1.41,P=0.59)。结论英夫利息单抗和环孢菌素在治疗重症难治性溃疡性结肠炎后的结肠切除率和并发症的发生率差异均无统计学意义。

Meta-analysis of efficacy of ciclosporin and infliximab in treatment of severe refractory ulcerative colitis

Objective To compare the rate of colectomy and complication between patients treated with ciclosporin and infliximab for severe refractory ulcerative colitis. Methods All relevant studies were searched by PubMed, EMBASE, and Coehrane Library databases. Odds ratio with 95% CI were calculated using fixed or random effect model in Review Manager version 5.1. Primary items were 3- and 12-month colectomy and complication. Results Overall, 9 papers were included in the Meta-analysis. Among them, 6 were retrospective studies, 2 were prospective studies, and 1 was multi-center randomized controlled trial. For the 3-month coleetomy rate, OR was 1.48 （95% CI： O. 61 -3.62, P =0.39） ; for the 12-month colectomy rate, OR was 1.36 （95% CI： O. 59 - 3.12, P =0.47） ; for the complication, OR was 0.88 （95% CI： O. 54 - 1.41, P = 0.59）. Conclusion Colectomy and complication rates are similar between patients treated with ciclosporin and infliximab.