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目的系统评价替加环素联合治疗鲍曼不动杆菌感染的疗效与安全性。方法计算机检索Cochrane图书馆、EmBase、PubMed、Web of Science、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(VIP)和万方数据库(检索时间均从建库至2016年7月)关于替加环素联合治疗鲍曼不动杆菌的随机对照试验、队列研究。由2名研究者按入选与排除标准独立筛选试验,并对纳入研究的方法学质量进行评价,提取资料;用RevMan5.14软件对数据进行Meta分析。结果共纳入12篇随机对照研究,5篇高质量的队列研究,共涉及1908例病例,其中试验组(替加环素联合治疗组)992例,对照组(其他抗鲍曼不动杆菌药物治疗组)916例。Meta分析结果显示:试验组临床有效率优于对照组,差异有统计学意义(P<0.05);试验组与对照组在微生物清除率、30 d死亡率方面差异均无统计学意义(P>0.05)。结论基于现有临床证据,替加环素联合治疗鲍曼不动杆菌感染,临床有效,但对于微生物清除及30 d死亡率的影响并不优于其他常规的药物治疗组。由于纳入研究数量较少,研究质量不统一,本结论还需要更多大样本、高质量临床随机对照试验予以验证。
Objective To systematically evaluate the efficacy and safety of tigecycline combined with Acinetobacter baumannii infection. Methods The Cochrane Library, EmBase, PubMed, Web of Science, CNKI, CBM, VIP and Wanfang Database were searched by computer. Library until July 2016) Randomized controlled trial on the combination of tigecycline with Acinetobacter baumannii in a cohort study. Two researchers independently selected the screening and exclusion criteria and evaluated the methodological quality of the included studies to extract the data. Meta-analysis was performed using RevMan5.14 software. Results A total of 12 RCTs and 5 high-quality cohort studies were enrolled. A total of 1908 cases were involved, of which 992 patients in the test group (tigecycline combined treatment group) and 992 patients in the control group (other anti-Acinetobacter baumannii drug treatment Group) 916 cases. Meta analysis showed that the clinical effective rate of the experimental group was better than that of the control group (P <0.05), and there was no significant difference between the experimental group and the control group in the microbial clearance rate and the 30-day mortality rate (P> 0.05). Conclusions Based on the available clinical evidence, tigecycline combined treatment of Acinetobacter baumannii infection is clinically effective, but the impact on microbial clearance and 30-day mortality is not superior to other conventional drug treatment groups. Due to the small number of studies included and the inconsistencies in the quality of the studies, more large samples are needed for this conclusion and high-quality clinical randomized controlled trials are to be performed.