|
| 酪氨酸激酶抑制药用于抗肿瘤治疗致肝毒性的Meta分析 |
| Meta analysis of the Risk of Tyrosine Kinase Inhibitors induced Hepatotoxicity in Cancer Patients |
| |
| DOI： |
| 中文关键词: Meta分析 酪氨酸激酶抑制药 安全性 肝毒性 |
| 英文关键词:Meta analysis Tyrosine kinase inhibitors Safety Hepatotoxicity |
| 基金项目: |
|
| 摘要点击次数: 1573 |
| 全文下载次数: 863 |
| 中文摘要: |
| 摘 要 目的：综合评价肿瘤患者使用酪氨酸激酶抑制药（TKI）导致肝毒性的风险，为临床治疗提供循证参考。方法：计算机检索PubMed、EMBase、SinoMed、Cochrane图书馆、中国期刊全文数据库、万方数据库，搜集TKI对比安慰剂治疗肿瘤的随机对照试验（RCT），筛选文献，提取资料，采用RevMan 5.2统计软件进行Meta分析。结果：共纳入13篇文献，合计3 931例受试者。Meta分析结果显示，TKI组丙氨酸氨基转氨酶（ALT）升高≥3级的发生率 （OR=3.77，95%CI：2.08~6.83，P<0.000 1），天门冬氨酸氨基转氨酶（AST）升高≥3级的发生率（OR=3.85，95%CI：2.55~5.82，P<0.000 1）显著高于对照组，而血清总胆红素（TB）升高≥3级的发生率（OR=1.89，95%CI：0.90~3.96，P=0.09）与对照组相比差异无统计学意义。结论：现有的证据表明肿瘤患者使用TKI发生肝毒性的风险显著升高，提示在临床用药过程中，需对患者肝功能进行定期检查及监护。 |
| 英文摘要: |
| ABSTRACT Objective: To systematically evaluate the risk of hepatotoxicity associated with the use of tyrosine kinase inhibitors (TKIs) in cancer patients.Methods:A comprehensive literature search of randomized control trials involving TKIs was performed. Only randomized, double blind and placebo controlled trials were included. The included studies must involve the comparison of a TKI against placebo, or the comparison of TKI with chemotherapy agent against placebo with the same chemotherapy agent. Meta analysis was performed by RevMan 5.2 software. Results: Thirteen articles were included in the analysis. The odds of hepatotoxicity due to elevation in alanine transaminase (grade 3 or above) (OR=3.77, 95%CI:2.08-6.83，P<0.000 1), aspartate transaminase (grade 3 or above) (OR=3.85，95%CI:2.55-5.82，P<0.000 1) and total bilirubin (grade 3 or above) (OR=1.89，95%CI:0.90-3.96，P=0.09) was higher with the use of TKI than compared to the controls. Conclusion:There was a significant increase in the odds of developing high grade (grade 3 or above) hepatotoxicity with the use of TKIs compared to the control arms. Clinicians should be aware of this risk and provide close monitoring in patients receiving these therapies. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
