兰州大学机构库 >第一临床医学院
孟鲁司特对过敏性紫癜患儿肾脏保护作用的Meta分析
Alternative TitleMeta-analysis on The Protection of Montelukast for The Kidneys of The Children With Henoch-schönlein Purpura
谢岚
Subtype硕士
Thesis Advisor李宇宁
2016-06-01
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword过敏性紫癜 紫癜性肾炎 孟鲁司特 随机对照试验 Meta分析
Abstract目的:本研究通过Meta分析方法评价孟鲁司特对过敏性紫癜患儿的肾脏保护作用,为进一步预防和减轻儿童紫癜性肾炎提供循证科学的治疗方法。 方法:检索中文数据库:中国期刊全文数据库、中国生物医学文献数据库、维普中文期刊数据库、万方数据库;外文数据库:Pubmed、Cochrane Library、Embase、Medline。全面收集关于孟鲁司特医治儿童过敏性紫癜的随机对照试验的相关文献。制定文献纳入与排除标准,经两名研究人员筛选与评价,根据Cochrane Handbook 5.1.0风险偏倚评估工具对纳入的文献进行质量评价。利用RevMan5.3统计软件对所有符合标准的文献中提取的数据进行Meta分析。 结果:通过全面检索,共收集到相关文献353篇,中文文献351篇,英文文献2篇。最终纳入11篇文献进入Meta分析。其中Sheng-HuaWu采用正确随机对照分组方法、分配隐藏、双盲、无退出和失访,无选择性报告和其他偏倚。其他十篇文献均采用随机对照方法,无退出和失访,无选择性报告和其他偏倚,但部分文献未涉及分配隐藏和盲法。整体文献基线资料具有可比性。Meta分析结果显示:孟鲁司特观察组总有效率为90.7%(196/216),对照组总有效率为74.4%(154/207),两组比较有统计学意义[RR合并=1.22(95%CI:1.11,1.33), P<0.0001 ]。其它指标,除尿白三烯E4[ SMD =-0.86(95%CI: -2.14,0.42),P=0.19]差异无统计学意义之外,尿转铁蛋白[SMD =-0.75(95%CI: -1.15,-0.34)] 、尿β2微球蛋白[SMD =-1.58(95%CI:-1.98,-1.18)]、血清β2微球蛋白[SMD =-7.22(95%CI:-8.12,-6.31)]、尿免疫球蛋白[SMD =-1.02(95%CI:-1.31,-0.73)]、尿微量白蛋白[SMD =-1.49(95%CI:-2.20,-0.79)]、尿α1微球蛋白[SMD=-0.35,(95%CI:-0.59,-0.11)],均P<0.05, 差异有统计学意义。对总有效率进行敏感性分析,结果基本稳定。 结论:现有证据证明,过敏性紫癜患儿在常规治疗基础之上应用孟鲁司特可一定程度地缓解肾脏损害症状,从而预防和减轻紫癜性肾炎的发生,不良反应较轻。但需通过大样本、多中心的高质量试验进一步确定。
Other AbstractObjective:By means of Meta analysis, this research evaluates the protection of montelukast for the kidneys of the children with henoch-schönlein purpura ,in order to provide evidence for further prevention and mitigation of henoch-schönlein purpura nephritis in children. Methods:Searched Chinese databases, including China National Knowledge Internet (CNKI), China Biomedical Literature Database (CBM), VIP Chinese periodical database and Wanfang database. Searched foreign language database, including PubMed, Cochrane Library, EMBASE, MEDLINE. Collect the literatures about the therapy of henoch-schönlein purpura with Montelukast comprehensively.Formulate standard of incorporating and excluding literatures, according to the screen and evaluation made by two researchers, carry out quality evaluation on the incorporated literature based on Cochrane Handbook 5.1.0 risk bias assessment. Conduct Meta analysis on the data extracted from all the literatures met the standards by using RevMan5.3 software system. Results:It searched 353 literatures in total, among which 351 are Chinese literatures while 2 are English literatures, and 11 literatures were incorporated into the Meta analysis. Hereinto, Sheng-HuaWu adopted the method of correct randomized controlled grouping, distribution concealing, blind experiment, no exit and lost follow-up, no-choice report, and other bias. Meanwhile, the other 10 literatures adopted randomized controlled method, no exit and lost follow-up, no-choice report, and other bias, but some did not mention distribution concealing or blind experiment. The overall literature baseline information has comparability, which is stable when carrying out sensitivity analysis.Meta-analysis showed: Montelukast observation group total effective rate was 90.7% (196/216),the total effective rate was 74.4% (154/207) in the control group, the two groups was statistically significant [RR = 1.22(95%CI:1.11,1.33), P<0.0001]. Other indexes, except for the urinary LTE4 [SMD = -0.86(95%CI: -2.14,0.42),P=0.19], there was no statistically significant difference, urinary TRF [SMD =-0.75(95%CI: -1.15,-0.34)],urinary β2-MG [SMD =-1.58(95%CI:-1.98,-1.18)], serum β2-MG [SMD =-7.22(95%CI:-8.12,-6.31)]、urinary IgG [SMD = =-1.02(95%CI:-1.31,-0.73)], urinary Alb [SMD =-1.49(95%CI:-2.20,-0.79)], urinaryα1-MG[SMD=-0.35,(95%CI:-0.59,-0.11)], all P < 0.05, Sensitivity analysis of the total efficiency, the results are basical...
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/201294
Collection第一临床医学院
Recommended Citation
GB/T 7714
谢岚. 孟鲁司特对过敏性紫癜患儿肾脏保护作用的Meta分析[D]. 兰州. 兰州大学,2016.
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