利福喷丁与利福平治疗肺结核疗效和安全性的Meta分析

J4 ›› 2011, Vol. 37 ›› Issue (3): 523-528.

利福喷丁与利福平治疗肺结核疗效和安全性的Meta分析

翟广^1|2|李波²|李玉芹¹|刘亚男¹|寇长贵²|姚燕²|赵书欣²

1.吉林省结核病医院内二疗区|吉林长春 130500；２.吉林大学公共卫生学院流行
病与卫生统计学教研室|吉林长春 130021

收稿日期:2010-07-31 出版日期:2011-05-28 发布日期:2011-05-28
作者简介:翟广（1976-）|女|吉林省九台市人|主管护师|医学硕士|主要从事结核病的防治研究。
基金资助:
吉林省卫生厅科研基金资助课题（2009 R006）

Meta-analysis on efficacy and safety of rifapentine and rifampicin in treatment of pulmonary tuberculosis

ZHAI Guang^1,2,LI Bo², LI Yu-qin¹, LIU Ya-nan¹, KOU Chang-gui²,YAO Yan2,ZHAO Shu-xin²

1.Department of Internal Medicine, Tuberculosis Hospital of Jilin Province,Cha
ngchun 130500,China|2. Department of Epidemiology and Health Statistics,School of Public Health,Jilin University,Changchun 130021,China

Received:2010-07-31 Online:2011-05-28 Published:2011-05-28
Contact: 李波（Ｔel：0431-85619451，E-mail：li_bo@jlu.edu.cn）；赵书欣（Ｔel：0431-85619451，E-mail：zshx5826@yahoo.com.cn） E-mail:E-mail：li_bo@jlu.edu.cn；zshx5826@yahoo.com.cn）

摘要/Abstract

摘要：

目的：通过Meta分析方法评价利福喷丁与口服利福平治疗肺结核的疗效和安全性，为利福喷丁在临床上的应用提供较为科学、可靠的循证医学证据。方法：计算机检索Ovid-medline、CBMdisc、Pubmed、CNKI、万方及维普等数据库，手工检索肺结核相关的专业杂志，检索1999—2010年国内外期刊公开发表的关于利福喷丁与利福平治疗肺结核疗效和安全性的临床随机对照试验（RCT）或临床对照试验（CCT）文献（检索日期截止至2010年7月）。结果：共纳入RCT 18篇，CCT 6篇。疗效方面，利福喷丁与利福平在初治肺结核组2个月痰菌阴转率、复治肺结核组疗程结束时病灶显效率及空洞闭合率、疗程结束后随访2～3年复发率比较差异均有统计学意义（P<0.05），利福喷丁组均优于利福平组；二者治疗复治肺结核2个月痰菌阴转率及疗程结束时初、复治肺结核组痰菌阴转率比较差异无统计学意义(P>0.05)，疗程结束时初治肺结核组病灶显效率及空洞闭合率比较差异也无统计学意义（P>0.05）。安全性方面，利福喷丁与利福平组药物过敏反应(皮疹、药物热)发生率比较差异无统计学意义（P>0.05），总的药物副反应发生率、肝功异常发生率、ALT升高发生率、血清胆红素升高发生率、胃肠道不良反应发生率及药物中止治疗发生率比较利福喷丁组均低于利福平组（P<0.05）。结论：利福喷丁治疗肺结核疗效好，安全性较高，患者耐受性及依从性好，尤其适合复治肺结核患者的化疗。

关键词: 利福喷丁；利福平；肺结核；Meta分析

Abstract:

Objective To evaluate the efficacy and safety of rifapentine(RPT) and rifampicin(RFP) in treatment of pulmonary tuberculosis with Meta-analysis,and provide a reliable and scientific evidence of evidence-based medicine for c
linical application of RPT in tuberculosis treatment. Methods The articles related to the efficacy and safety of RPT and RFP in the treatment of pulmonary tuberculosis,and randomized clinical controlled trials （RCT）or clinical controlled trials（CCT）published in the openly journals either in Chinese or English from 1999 to July 2010 were searched by computer. The databases were as follows:Ovid-medline,CBMdisc,Pubmed,CNKI,Wanfang database and Weipu database. Some pulmonary tuberculosis journals which didn’t publish on line had also been searched by hand. Results There were 18 RCTs and 6 CCTs were finally selected. In the aspect of efficacy,the 2-month sputum negative conversion rate of the primary treated tuberculosis cases,the obvious effective rate and curable rate of cavity at the end of treatment period of relapse tuber
culosis and recurrence rate of tuberculosis in the following 2 or 3 years after treatment period of the relapse tuberculosis cases were all significantly different between RPT and RFP groups,respectively（P<0.05）. RPT was more effective than RFP . There were no significant differences between two groups on other indexes,such as 2-month sputum negative conversion rate of the relapse tuberculosis cases,and sputum negative conversion rates both of the primary and relapse tuberculosis cases at the end of treatment period of tuberculosis,and obvious effective rate and curable rate of cavity at the end of the treatment period of the primary treated tuberculosis cases（P>0.05）. As for the evaluation of safety，the combined analysis results showed that skin rash and drug fever showed no significant differences（P>0.05），other indexes all showed significant differences between two groups (P<0.05),such as total drug side-effects，abnormal liver function，ALT elevating，serum bilirubin elevating,gastrointestinal adverse reactions,and discontinuation of medication. RPT had less side effects than RFP. Conclusion RPT is safe and effective to treat pulmonary tuberculosis,especially for relapse cases. Besides,the patients possibly have better tolerance and adherence to RPT than RFP.

Key words: rifapentine;rifampincin;tuberculosis;Meta-analysis

中图分类号:

R521

翟广|李波|李玉芹|刘亚男|寇长贵|姚燕|赵书欣. 利福喷丁与利福平治疗肺结核疗效和安全性的Meta分析[J]. J4, 2011, 37(3): 523-528.

ZHAI Guang,LI Bo,LI Yu-qin,LIU Ya-nan, KOU Chang-gui,YAO Yan,ZHAO Shu-xin. Meta-analysis on efficacy and safety of rifapentine and rifampicin in treatment of pulmonary tuberculosis[J]. J4, 2011, 37(3): 523-528.