小剂量激素对类风湿性关节炎患者的远期疗效被引量：10

A meta-analysis of efficacies of low dose prednisolone in treatment of patients with rheumatoid arthritis

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摘要目的系统评价小剂量糖皮质激素(<15mg/d)治疗类风湿性关节炎的远期疗效以及安全性。方法检索小剂量糖皮质激素治疗类风湿性关节炎的随机临床试验结果。用Revman4.2软件对入选的文献进行Meta分析。结果最终纳入14项研究,Meta分析结果:临床有效率的合并OR值为1.50,95%CI:1.18～1.92,P=0.001;骨关节有效率的合并OR值为0.87,95%CI:0.66～1.55,P=0.32;小剂量激素对Sharp评分影响的合并OR值为-5.84,95%CI:-6.73～-4.95,P<0.000 01;对骨质侵蚀分数影响的合并OR值为-4.34,95%CI:-4.63～-3.99,P<0.000 01;对关节狭窄分数影响的合并OR值为-1.03,95%CI:-1.31～-0.75,P<0.000 01;对健康评定问卷(HAQ)评分和握力比较差异无统计学意义。结论小剂量糖皮质激素治疗类风湿性关节炎远期疗效较好且不会引起不良反应。 Objective To evaluate the long term efficacy and satety of low dose prednisolone（15 mg daily） in comparison with placebo and nonsteroidal antiinflammatory drugs in patients with rheumatoid arthritis.Methods Searching clinical trials about treatment RA with low dose prednisolone.The data were analysed by Revman4.2 software.Results 14 studies were included in the metaanalysis.Prednisolone group had a marked effect over control group on the rate of achievement of ACR 20%,OR 1.50（95%CI 1.18 to 1.92）,P=0.001.Bone erosion and joint space narrowing were measured radiographically,OR 0.87（95%CI 0.66 to 1.55）,P=0.32,Prednisolone group also had a greater effect than control group on Sharp scale,OR-5.84（95% CI-6.73 to-4.95）and erosion score,OR-4.34（95% CI-4.63 to-3.99） and joint space narrowing,OR-1.03（95% CI-1.31 to-0.75）,whereas the difference in HAQ and grips trength was not significant.Conclusion Long term prednisolone in low doses is effective in the treatment of RA.In addition,it did not induce side-effects in the patients.

作者潘殊方施珍谷定英蔡晖周志宏

机构地区温州医学院附属第二医院肾内科美国Emory大学医学院肾脏科

出处《重庆医学》 CAS CSCD 北大核心 2012年第2期119-121,共3页 Chongqing medicine

关键词糖皮质激素类关节炎类风湿 META分析 glucocorticoids arthritis rheumatoid Meta-analysis

分类号 R593.22 [医药卫生—内科学]

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参考文献14

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二级参考文献21

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