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目的对艾滋病患者预防性应用伊曲康唑的有效性进行Meta分析,为临床合理使用伊曲康唑预防艾滋病患者真菌感染提供依据。方法制定检索策略,检索Cochrane图书馆临床对照试验数据库、PubMed、EMbase、EBSCO、万方和清华同方数据库,时间从1981年1月~2013年7月,收集有关对艾滋病患者预防性应用伊曲康唑的随机对照临床研究。应用Stata 10.0软件进行Meta分析,采用异质性检验(齐性检验),统计合并效应量,得出合并后的RR值及其95%CI值。结果共3篇文献符合纳入标准进入Meta分析。结果显示,预防性应用伊曲康唑可以明显降低艾滋病患者的总体真菌感染率,RR=0.54(95%CI:0.44~0.67),P<0.05;而侵袭性真菌感染率差异无统计学意义,RR=0.38(95%CI:0.13~1.10),P>0.05;病死率差异无统计学意义,RR=1.14(95%CI:0.79~1.65),P>0.05。结论艾滋病患者预防性应用伊曲康唑可以明显降低总体真菌感染率,目前对侵袭性真菌感染并未显示有预防效果。对于艾滋病患者是否预防性应用伊曲康唑,需要仔细评估,要根据不同疾病阶段的真菌感染率制定不同的预防策略。
Objective To analyze the efficacy of itraconazole in the prevention of AIDS in patients with AIDS by Meta-analysis, and provide a basis for the clinical use of itraconazole in the prevention of fungal infections in AIDS patients. Methods To develop a search strategy and search the Cochrane Central Register of Controlled Trials Database, PubMed, EMbase, EBSCO, Wanfang and Tsinghua Tongfang databases from January 1981 to July 2013 to collect information on the preventive use of itracon A Randomized Controlled Clinical Study of. Meta-analysis was performed using Stata 10.0 software. The heterogeneity (homogeneity) test was used to calculate the combined effect and the combined RR and 95% CI values were obtained. Results A total of 3 articles met the inclusion criteria for Meta-analysis. The results showed that prophylactic use of itraconazole could significantly reduce the overall fungal infection rate of AIDS patients, RR = 0.54 (95% CI: 0.44-0.67), P <0.05; while the rate of invasive fungal infection was not statistically significant, RR = 0.38 (95% CI: 0.13-1.10), P> 0.05. There was no significant difference in mortality between the two groups (RR = 1.14, 95% CI: 0.79-1.65), P> 0.05. Conclusion The prophylactic use of itraconazole in patients with AIDS can significantly reduce the overall fungal infection rate, the current invasive fungal infection did not show a preventive effect. Whether it is prophylactic use of itraconazole in AIDS patients needs to be carefully evaluated, and different prevention strategies should be formulated according to the fungal infection rates at different disease stages.