霉酚酸酯与环磷酰胺治疗弥漫增生性狼疮肾炎的Meta分析

目的评价霉酚酸酯与环磷酰胺治疗弥漫性增生性狼疮肾炎的有效性和安全性。方法计算机检索PUBMED和中国期刊网等数据库,收集霉酚酸酯与环磷酰胺治疗弥漫增生性狼疮肾炎的前瞻、随机对照实验,使用Meta分析的方法评价治疗的有效率、复发率、死亡率、24 h尿蛋白定量、血肌酐水平、肾组织学活动性指数、肾组织学慢性化指数、感染、白细胞减少、闭经和腹泻等情况。结果共有10篇文献纳入研究。肾组织学活动性指数改善,霉酚酸酯较环磷酰胺效果好(P<0.05),而感染、白细胞减少、闭经等的发生,霉酚酸酯较环磷酰胺机会低(P<0.05)。结论霉酚酸酯在改善肾组织学活动性指数和安全性上较环磷酰胺为优。

Meta-analysis of mycophenolate mofetil versus cyclophosphamide for diffuse proliferative lupus nephritis

Objective To evaluate the efficacy and safety of mycophenolate mofetil and cyclophosphamide in treating diffuse proliferative lupus nephritis. Methods Published papers on randomized,controlled and prospective clinical trials about mycophenolate mofetil and cyclophosphamide used to treat diffuse proliferative lupus nephritis were collected from PUBMED and CNKI,meta-analysis was made to evaluate the remission,relapse,death,24-hr urine protein,serum creatinine,activity index of disease,chronic index of disease,infection,leucopenia,amenorrhea and diarrhea. Results Altogether 10 papers are included in the study.In declining activity index of disease,mycophenolate mofetil is better than cyclophosphamide in treatment for diffuse proliferative lupus nephritis(P <0.05),and the incidence of infection,leucopenia and amenorrhea after mycophenolate mofetil treatment is lower than cyclophosphamide in treatment for diffuse proliferative lupus nephritis(P <0.05). Conclusion In treating diffuse proliferative lupus nephritis,mycophenolate mofetil is better than cyclophosphamide on the decline of activity index and safety.