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探究氧氟沙星我国左氧氟沙星治疗耐多药肺结核疗效系统评价生

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论文导读:otalof26RCTsinvolving2791caseswereincluded.Theresultsofmeta-analysisshowedtheefficacyoflevofloxacininthesputumnegativeconversionrate,thefocusabsorptionandcityclosureratewassignificantlybetterthanthatofpasiniazid,rifapentine,ethambutolandamikacinascompared
摘 要 目的:系统评价我国左氧氟沙星治疗耐多药肺结核的疗效。方法:计算机检索万方数据库、中国期刊全文数据库、中华医学会期刊数据库,并辅以手工检索,收集我国左氧氟沙星治疗耐多药肺结核的所有随机对照试验,检索文献发表时间为2000年至2012年。并采用Jadad量表对纳入研究进行质量评价后,用RevMan 5.0软件进行荟萃分析。结果:最终纳入26个随机对照试验,合计2 791例患者。荟萃分析结果显示:与对照组相比,左氧氟沙星组患者痰菌阴转、病灶吸收以及空洞闭合情况均明显高于对照组中的对氨基水杨酸异烟肼片,利福喷丁,乙胺丁醇,阿米卡星等药物。结论:左氧氟沙星治疗耐多药肺结核安全有效,但由于文献数量有限,质量较低,有待于大样本、高质量的研究进一步研究验证。
关键词 左氧氟沙星 耐多药肺结核 系统评价 荟萃分析 随机对照试验
1006-1533(2013)11-0018-05
Effectiveness of levofloxacin for multidrug
resistant pulmonary tuberculosis: a systematic review
SUN Ying1,2, WEN Hua1
(1. Department of Respiratory Medicine, The First Hospital of China Medical University, Shenyang 110001, China;
2. Department of Respiratory Medicine, China Shenyang Chest Hospital, Shenyang 110044, China)
ABSTRACT Objective: To systematically evaluate the effectiveness of levofloxacin in controlling multidrug resistant tuberculosis (MDR-TB). Methods: Literatures in databases such as Wanfang database、CNKI and Periodical database of the Chinese Medical Association from 2000 to 2012 were searched, sometimes with the aid of hand searching to collect randomized controlled trials on levofloxacin used to treat MDR-TB, in which their quality was evaluated by adopting the Jadad scale and meta-analysis was performed by RevMan 5.0 software. Results: A total of 26 RCTs involving 2 791 cases were included.The results of meta-analysis showed the efficacy of levofloxacin in the sputum negative conversion rate, the focus absorption and city closure rate was significantly better than that of pasiniazid, rifapentine, ethambutol and amikacin as compared with the placebo group. Conclusion: Levofloxacin for the treatment of MDR-TB is safe and effective. However, because of the limited number and low quality of literatures, it may need large sample and high quality of research to论文导读:ltidrug源于:免费毕业论文www.7ctime.comresistantpulmonarytuberculosis;systematicreview;meta-analysis;randomizedcontrolledtrial结核病是全世界最普遍的传染性疾病之一,目前其发病率呈增高趋势。我国是结核病高负担国家之一,而且结核耐药形势严峻。由于化疗方案不合理或病人的治疗依从性差及医生督导任
be further verified.
KEY WORDS levofloxacin; multidrug源于:免费毕业论文www.7ctime.com
resistant pulmonary tuberculosis; systematic review; meta-analysis; randomized controlled trial
结核病是全世界最普遍的传染性疾病之一,目前其发病率呈增高趋势。我国是结核病高负担国家之一,而且结核耐药形势严峻。由于化疗方案不合理或病人的治疗依从性差及医生督导任务的难以执行,结核杆菌的耐药问题更是日趋严重。耐多药结核病是指至少由耐异烟肼及利福平两种抗结核药物的结核分枝杆菌感染引起的结核病。耐药性结核病的治疗效果差,耐多药结核菌的流行将严重影响结核病疫情的有效控制。左氧氟沙星是目前抗菌谱较广的氟喹诺酮类药物,具有较强的抗结核分枝杆菌活性,广泛用于治疗耐多药结核病(MDR-TB)。据WHO估算,全球每年MDR-TB发病人数30~60万,中国的MDR-TB病人数占全球总病人数的1/4~1/3。我国《肺结核诊断及治疗指南》[3]中规定诸如左氧氟沙星等二线抗结核药物是治疗耐多药肺结核病的主药,有研究表明,其使用率在我国高于80%。由于选取的比较对象及治疗病例的不同,在某些研究中,左氧氟沙星对耐多药肺结核治愈率接近100%[4],但在某些研究中低于40%。不同的研究结果,影响临床医生决策。本文采用Cochrane系统评价方法,评价左氧氟沙星治疗耐多药肺结核的有效性,以期为临床决策提供依据。摘自:论文范文www.7ctime.com
摘自:本科生毕业论文范文www.7ctime.com