替加环素治疗耐碳青霉烯类肺炎克雷伯菌效果的Meta分析

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摘要目的系统评价替加环素单药治疗以及联合治疗耐碳青霉烯类肺炎克雷伯菌的效果。方法通过计算机检索自建库到2018年9月Cochrane图书馆、EmBase、PubMed、中国期刊全文数据库（CNKI）以及中国生物医学文献数据库（CBM）关于替加环素治疗耐碳青霉烯类肺炎克雷伯菌的临床研究。由2名研究者按入选与排除标准独立筛选试验，并对纳入研究的方法学质量进行评价，提取资料，采用Review Manager 5.3软件对数据进行Meta分析，计算比值比（OR）和95%置信区间（95%CI）。结果最终本研究纳入了9篇临床试验。替加环素单药治疗与其他单药治疗对耐碳青霉烯类肺炎克雷伯菌感染患者的死亡率比较，差异无统计学意义（OR=1.07，95%CI=0.63～1.82，P=0.8）。以替加环素为基础的联合治疗与其他药物联合治疗相比，对耐碳青霉烯类肺炎克雷伯菌感染患者的死亡率差异无统计学意义（OR=1.40，95%CI=0.89～2.21，P=0.15）。结论无论是替加环素单药还是以替加环素为基础的联合治疗，均不能有效改善耐碳青霉烯类肺炎克雷伯菌感染患者的死亡率。本结论尚需要更多大样本、高质量的临床随机对照试验予以证实。

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	侯思远
	谭永峰
	冯星火

关键词 ：替加环素, 耐碳青霉烯类肺炎克雷伯菌, 单药治疗, 联合治疗, Meta分析

Abstract：Objective To systematically evaluate the efficacy of Tegacycline monotherapy and combination therapy in the treatment of carbapenem-resistant Klebsiella pneumonia （CRKP）infections.Methods The clinical studies of Tegacycline in the treatment of CRKP were retrieved from Cochrane Library，Embase，Pubmed，China National Knowledge Infrastructure （CNKI）and China Biology Medicine disc （CBM）by computer from the construction of the library to September 2018.Two reviewers independently retrieved studies according to the inclusion and exclusion criteria，assessed the methodological quality of included trials，and extracted data.The data analysis was performed by Review Manager 5.3 software.The odds ratio （OR）and 95%confidence intervals （CI）were calculated for outcome analysis.Results A total of 9 studies were included in this study.There was no significant difference in the mortality of CRKP infection between Tegacycline monotherapy and other monotherapy（OR=1.07，95%CI=0.63-1.82，P=0.8）.There was no significant difference in mortality among CRKP patients treated with Tigacycline-based combination therapy compared with other drugs combination therapy（OR=1.40，95%CI=0.89-2.21，P=0.15）.Conclusion Both Tigecycline monotherapy and Tigecycline-based combination therapy do not significantly improve the mortality of patients with CRKP infections.This conclusion needs more large sample and high quality clinical randomized controlled trials to confirm.

Key words： Tigecycline Carbapenem-resistant Klebsiella pneumoniae Monotherapy Combination therapy Meta analysis

作者简介: 侯思远（1987-），男，硕士，主治医师，主要研究方向：脓毒症的治疗

引用本文:

侯思远；谭永峰；冯星火. 替加环素治疗耐碳青霉烯类肺炎克雷伯菌效果的Meta分析[J]. 中国当代医药, 2019, 26(6): 64-67.
HOU Si-yuan ；TAN Yong-feng ；FENG Xing-huo. Meta analysis of efficacy of Tigecycline in the treatment of carbapenemresistant Klebsiella pneumoniae infections. 中国当代医药, 2019, 26(6): 64-67.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2019/V26/I6/64

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