摘要
目的应用荟萃分析评价拉米夫定治疗乙肝肝硬化国内文献的疗效。方法对2000年1月—2006年12月在国内生物医学期刊有关拉米夫定治疗乙肝肝硬化的临床随机对照试验进行质量评价。结果纳入8个RCT(n=578)研究拉米夫定100mg/d治疗乙肝肝硬化的疗效,纳入文献的总体方法学质量较高,4篇Jadad评分为3分以上,但在随机化方法、分配隐藏和盲法的使用方面重视不够。分析结果显示,使用拉米夫定可明显促使ALT复常,对Child-Pugh评分与对照组相比有统计学意义(P<0.05),短期内使用拉米夫定对HBVDNA转阴率与对照组相比有统计学意义(P<0.05),但长期则无统计学意义(P>0.05)。拉米夫定治疗组的HBeAg转阴率与对照组相比无统计学意义(P>0.05)。结论拉米夫定治疗乙肝肝硬化是安全的,它可使ALT复常,降低Child-Pugh评分,但对远期HBVDNA和HBeAg阴转率尚无足够证据说明。
Objective To evaluate the clinical effect of lamivudine for hepatitis B patients with liver cirrhosis in China by metaanalysis. Methods The biomedical science periodicals database from January 2000 to Decomber 2006 was searched for randomized controlled trials of lamivudine in hepatitis B liver cirrhosis. Results Eight RCTs were included （ n = 578 ）. All reported the effect of lamivudine （ 100 rag/d） on hepatitis B patients with liver cirrhosis. As a whole method quality of included studies was high, four RCTs Jadad scores were over 3, but were insufficient in randomisation way, allocation concealment and blindness. It was found by metaanalysis that lamivudine could normalize ALT. Difference of Child-Pugh scores of lamivudine had statistical significance compared with control group, HBV DNA negative conversion rate in short term had statistical significance compared with control group, but had no statistical significance for a long period. Iamivudine group had no statistical significance in HBeAg seroeonversion rate compared with the control group.Conclusion Lamivudine （ 100 mg/d） is safe and effective for hepatitis B patients with liver cirrhosis in normalizing ALT, reducing Child-pugh scores, but had no saffieient evidence in achieving HBV DNA and HBeAg seroeonversion.
出处
《肝脏》
2007年第5期346-350,共5页
Chinese Hepatology
关键词
拉米夫定
乙型肝炎
肝硬化
荟萃分析
Lamivudine
Hepatitis B
Liver cirrhosis
Meta-analysis
