發(fā)布時(shí)間：2018-01-13 14:12

  本文關(guān)鍵詞：聯(lián)合雷特格韋用于HIV-1初次治療有效性和安全性的Meta分析　出處：《中華疾病控制雜志》2017年05期 　論文類型：期刊論文

  更多相關(guān)文章： HIV 獲得性免疫缺陷綜合征 Meta分析 隨機(jī)對照試驗(yàn)

【摘要】：目的評價(jià)聯(lián)合雷特格韋治療方案用于人類免疫缺陷病毒-1(human immunodeficiency virus 1,HIV-1)初次抗病毒治療的安全性和有效性。方法檢索聯(lián)合雷特格韋用于HIV-1感染者初次抗病毒治療的臨床隨機(jī)對照試驗(yàn)(randomized controlled trial,RCT),采用Rev Man 5.2軟件和Stata 12.0進(jìn)行Meta分析。結(jié)果納入17個(gè)RCT,Meta分析結(jié)果:以血漿病毒載量50拷貝/ml為治療有效。在治療48周及96周,試驗(yàn)組有效率分別為84.21%、87.30%,與對照組相比差異均無統(tǒng)計(jì)學(xué)意義(均有P0.05);治療240周,試驗(yàn)組有效率高于對照組(70.2%和61.5%),合并效應(yīng)量(RR=1.15,95%CI:1.03~1.28,P=0.010)。試驗(yàn)組與對照組在腹瀉、惡心、頭暈、頭痛、失眠等常見不良反應(yīng)差異均無統(tǒng)計(jì)學(xué)意義(均有P0.05);其中96周及144/156周時(shí)脂質(zhì)代謝異常增高合并效應(yīng)量RR(95%CI)分別為:低密度脂蛋白0.16(0.05~0.49)、0.20(0.08~0.48),甘油三酯0.12(0.02~0.59)、0.12(0.03~0.59),總膽固醇0.04(0.00~0.40)、0.04(0.00~0.34)。脂質(zhì)代謝指標(biāo)異常增高發(fā)生率,試驗(yàn)組均少于對照組,差異均有統(tǒng)計(jì)學(xué)意義(均有P0.05)。結(jié)論雷特格韋聯(lián)合核苷類逆轉(zhuǎn)錄酶抑制劑、非核苷類逆轉(zhuǎn)錄酶抑制劑或蛋白酶抑制劑可以作為HIV-1/艾滋病初次抗病毒治療的可選方案,與目前推薦的抗病毒治療方案療效相當(dāng),且安全性較好,其中脂質(zhì)代謝異增高常明顯減少,但受納入研究對象的限制,需要更多研究進(jìn)一步證驗(yàn)證。
[Abstract]:Objective to evaluate the efficacy of combined therapy with Retgvir in the treatment of human immunodeficiency virus (HIV-1) human immunodeficiency virus 1 (virus 1). Methods the efficacy and safety of primary antiviral therapy for HIV-1. Methods the clinical randomized controlled trial (RCTT) combined with Rategevel for the first time antiviral therapy in patients with HIV-1 was retrieved. Randomized controlled trial. Rev Man 5.2 software and Stata 12.0 were used for Meta analysis. The results were included in 17 RCT. Meta analysis showed that the plasma viral load of 50 copies / ml was effective. At 48 and 96 weeks of treatment, the effective rates of the test group were 84.21% and 87.30%, respectively. There was no significant difference between the control group and the control group (P 0.05). After 240 weeks of treatment, the effective rate in the trial group was higher than that in the control group (70.2% and 61.5%). There was no significant difference in common adverse reactions such as diarrhea, nausea, dizziness, headache and insomnia between the experimental group and the control group (P 0.05). In 96 weeks and 144/156 weeks, the combined effect of abnormal increase of lipid metabolism was 0.165U 0.49 (RRN 95CI), respectively. 0.20, 0.08, 0.48, triglyceride, 0.12, 0.02, 0.59, 0.12, 0.03, 0.59). The incidence of abnormal increase of lipid metabolism index in the trial group was lower than that in the control group. The difference was statistically significant (P 0.05). Conclusion Retergevir combined with nucleoside reverse transcriptase inhibitors. Non-nucleoside reverse transcriptase inhibitors or protease inhibitors can be used as the first anti-viral treatment of HIV-1 / AIDS, the efficacy is comparable to the current recommended anti-viral treatment, and the safety is good. The abnormal increase of lipid metabolism often decreased significantly, but limited by the subjects involved, more studies were needed to verify it.
【作者單位】： 廈門大學(xué)公共衛(wèi)生學(xué)院;分子疫苗學(xué)與分子診斷學(xué)國家重點(diǎn)實(shí)驗(yàn)室 國家傳染病診斷試劑與疫苗工程技術(shù)研究中心;廈門大學(xué)生命科學(xué)學(xué)院;蘭州大學(xué)循證醫(yī)學(xué)中心;山西醫(yī)科大學(xué)公共衛(wèi)生學(xué)院流行病學(xué)教研室;
【基金】：國家自然科學(xué)基金(81371818) 福建省科技創(chuàng)新平臺(2014Y2004)
【分類號】：R512.91
【正文快照】： (Chin J Dis Control Prev 2017,21(5):504-509)【作者單位】1廈門大學(xué)公共衛(wèi)生學(xué)院,福建廈門3611022分子疫苗學(xué)與分子診斷學(xué)國家重點(diǎn)實(shí)驗(yàn)室,國家傳染病診斷試劑與疫苗工程技術(shù)研究中心,福建廈門3611023廈門大學(xué)生命科學(xué)學(xué)院,福建廈門3611024蘭州大學(xué)循證醫(yī)學(xué)中心,甘肅蘭州730

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本文編號：1419173