【作者】 张宁；

【机构】 大连医科大学附属二院药剂科；

【摘要】 目的运用循证药学方法评价西罗莫司在肝移植患者中的有效性及安全性。方法检索中国期刊网全文数据库(cnki),维普中文科技期刊全文数据库(vip),万方数据医药信息系统,中国生物医学文献服务系统(CBM),收集2000-2009年发表的西罗莫司在肝移植患者中应用的中文文献,以及检索SpringerLink和PubMed发表的西罗莫司在肝移植患者中应用的外文文献,对符合标准的文献进行循证药学分析:对纳入研究的方法学质量进行评价,同时采用RevMan4.2.2软件对相关数据进行Meta分析。结果共检索到文献2884篇,最终共有7个篇文献纳入研究,共841例患者。Meta分析结果显示,肝移植术后使用西罗莫司与否在患者存活情况方面和移植肝存活情况方面无统计学差异,结果分别为:[OR=1.46,95%CI(1.00,2.15),P=0.05]和[OR=1.59,95%CI(0.16,15.50),P=0.69];肝移植术后使用西罗莫司可以降低急性排斥反应的发生,结果显示为:[OR=0.73,95%CI(0.54,0.99),P=0.04];肝移植术后使用西罗莫司可以改善患者肾功能,结果显示为:[OR=13.44,95%CI(4.50,40.11),P<0.00001]。结论肝移植术后应用西罗莫司可以减少患者急性排斥反应的发生;可改善肾功能,但可能不会改变移植肝存活率,可能会导致病人发生高脂血症,口腔溃疡等轻度不良反应。更多还原

【Abstract】 OBJECTIVE To evaluate efficacy and safety of sirolimus for patients after liver transplantation. METHODS For the literature on sirolimus for patients after liver transplantation from 2000 to 2009, We searched China Journal Full-text Database(cnki), China Technology Periodical Full-text Database (vip), wanfang data medicine system, China Biomedical Database(CBM), and SpringerLink and PubMed. The iterature which was in accordance with the standard was analyzed using evidence-based pharmacy. Meta-analysis was performed using RevMan 4.2.2 software. RESULTS We searched 2884 papers. Seven literatures including 841 patients were investigated. The meta-analysis outcome showed:(1) no significant difference for survival was found between whether or not using sirolimus for patients or graft after liver transplantation. Statistics outcomes were OR=1.46, 95%CI (1.00, 2.15), P=0.05 and OR=1.59, 95%CI (0.16, 15.50),P=0.69 (2) Using sirolimus for patients after liver transplantation could reduce the acute rejection, statistics outcomes were OR=0.73, 95%CI (0.54, 0.99), P=0.04(3) using sirolimus for patients after liver transplantation could improve renal function, statistics outcomes were OR=13.44, 95%CI (4.50, 40.11), P<0.00001CONCLUSION using sirolimus for patients after liver transplantation could reduce acute rejection and improve renal function. However, there is no significant difference in patient survival,. Administration of sirolimus may cause hyperlipemia and dental ulce to summarize, sirolimus used for patients after liver transplantation are effective and safe.更多还原