许佳,程金辉,张子女,韩若冰,赵明沂,于净
XU Jia,CHENG Jinhui,ZHANG Zinuv,HAN Ruobing,ZHAO Mingyi,YU Jing

• 1:沈阳药科大学生命科学与生物制药学院
• 2:辽宁医药职业学院

摘要(Abstract)：

目的系统评价马ATG和兔ATG治疗再生障碍性贫血的有效性及安全性。方法在Cochrane图书馆,Pub M ed,Embase,Clinical Trials. gov、美国血液学会和欧洲血液骨髓移植学会年会会议记录等中进行文献检索,搜集2009年1月至2017年11月发表的相关临床研究文献,由2名研究者根据纳入与排除标准独立进行文献筛选及资料提取,并使用纽卡斯尔-渥太华(newcastleottaw a scale,NOS)质量评价量表对纳入的文献进行方法学质量评价。采用R软件4. 3. 3及RevM an软件5. 3进行M eta分析。结果最终纳入15篇文献,1 534例研究对象(试验组868例,对照组666例)。分析结果显示,试验组(马ATG组) 3,6个月总反应率显著优于对照组(兔ATG组)(RR=1. 32,95%CI,1. 04～1. 67,P=0. 02; I~2=56%; RR=1. 20,95%CI,1. 09～1. 32,P=0. 0002;I~2=48%),12个月总反应率两组没有明显差异(RR=0. 96,95%CI,0. 84～1. 09,P=0. 49; I~2=0%); 3个月早期死亡率试验组明显低于对照组(RR=0. 53,95%CI,0. 33～0. 83,P=0. 006;I~2=0%)。结论在6个月内马ATG疗效优于兔ATG; 12个月长期疗效两者没有明显差异; 3个月早期死亡率马ATG低于兔ATG。结合有效性及安全性考虑,在应用免疫抑制疗法治疗再生障碍性贫血时,选择马ATG更优于兔ATG。
Objective To systematically reviewevidence to compare the efficacy and safety of horse ATG( h ATG) and rabbit ATG( r ATG) in the treatment of aplastic anemia. Methods The literatures were searched in The Cochrane Library,PubM ed,Embase,Clinical Trials. gov and conference proceedings of American Society of Hematology and European Society for Blood and M arrowTransplantation annual meeting minutes,from January,2009 to November,2017. According to the inclusion and exclusion criteria,the literatures were selected and datas were extracted by two researchers,independently. Newcastle-Ottawa( NOS) quality assessment scale was used to evaluate the quality of the included literatures. The metaanalysis was performed by using R 4. 3. 3 and RevM an 5. 3. Results In this study,15 literatures including1534 participants were included,( experimental group 868 and control group 666). The result of meta analysis showed that the overall response rate at 3,6 months of experimental group( hATG) were better than control group( r ATG)( RR = 1. 32,95% CI,1. 04-1. 67,P = 0. 02; I~2= 56%; RR = 1. 20,95% CI,1. 09-1. 32,P = 0. 0002; I~2= 48%) No significant difference was found between experimental and control group in the overall response rate at 12 months( RR = 0. 96,95% CI,0. 84-1. 09,P = 0. 49; I~2= 0%). The early mortality rate at 3 months of the experimental group was significantly lower than the control group( RR =0. 53,95% CI,0. 33-0. 83,P = 0. 006; I~2= 0%). Conclusion Within 6 months,the treatment of aplastic anemia with hATG is better than with r ATG. Both ATGs are not significantly different at 12 months. The early mortality rate at 3 months in hATG is lower than hATG. Therefore,considering both efficacy and safety considerations,the choice of horse ATG is superior to that of rabbit ATG for the treatment of aplastic anemia with IST.

关键词(KeyWords)： 马ATG;兔ATG;再生障碍性贫血;Meta分析
horse ATG;rabbit ATG;aplastic anemia;meta-analysis

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 许佳,程金辉,张子女,韩若冰,赵明沂,于净
XU Jia,CHENG Jinhui,ZHANG Zinuv,HAN Ruobing,ZHAO Mingyi,YU Jing

DOI: 10.14066/j.cnki.cn21-1349/r.2018.10.012

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