头孢曲松治疗早期梅毒疗效的系统评价与Meta分析

摘要/Abstract

摘要： 【摘要】目的评价头孢曲松治疗早期梅毒的临床疗效。方法检索中英文文献数据库1985—2012年公开发表的有关头孢曲松治疗早期梅毒疗效研究的论著，使用Jadad评分对文献质量进行评价并纳入符合要求的文献，使用Stata 12.0软件进行Meta分析。结果共纳入符合条件的文献14篇，其中高质量文献5篇。以头孢曲松治疗有效率和青霉素治疗有效率的率比（RR值）为指标进行Meta分析。随访6个月、12个月、24个月时，两种药物的疗效差异无统计学意义。随访12个月时，头孢曲松组的有效率为92.3%（95% CI 88.5% ~ 96.1%），青霉素组有效率为90.4%（95% CI 87.4% ~ 94.4%）。漏斗图结果近似对称，发表偏倚较小。结论头孢曲松可作为治疗早期梅毒的替代方案，疗效确切。有必要开展多中心大样本的随机对照试验以优化治疗剂量与确定疗程。

关键词: 梅毒, 头孢曲松, Meta分析

Abstract: MEN Pei-xuan, GONG Xiang-dong. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China Corresponding author: GONG Xiang-dong, Email: gxdchina@163.com 【Abstract】 Objective To retrieve clinical evidence for the efficacy of ceftriaxone in the treatment of early syphilis. Methods Several international and national medical databases were used to search original articles published from 1985 to 2012 and reporting the efficacy of ceftriaxone or penicillin for the treatment of early syphilis. Randomized controlled trials （RCTs） and clinical controlled trials （CCTs） were identified and retrieved. The quality of studies was assessed using the Jadad scale. Eligible studies were selected according to an established strategy. A meta-analysis was performed by the Stata software version 12.0. Results A total of 14 RCTs or CCTs were eligible for this meta-analysis, including five high-quality trials. Response rate ratios were calculated for ceftriaxone-treated patients compared with penicillin-treated patients. The meta-analysis showed no significant difference in the efficacy between ceftriaxone and penicillin at 6-, 12- and 24-month follow-up visits. The response rate was 92.3% （95% CI: 88.5% － 96.1%） and 90.4% （95% CI: 87.4% － 94.4%） in ceftriaxone- and penicillin-treated patients respectively at the 12-month follow-up visit. Funnel plots were approximately symmetrical, indicating little publication bias. Conclusions Ceftriaxone may serve as an alternative treatment for early syphilis with reliable efficacy. However, multi-centered RCTs with large sample sizes are still needed to optimize the therapeutic dose and course of ceftriaxone for early syphilis.

Key words: Ceftriaxone, Meta-analysis

门佩璇龚向东. 头孢曲松治疗早期梅毒疗效的系统评价与Meta分析[J]. 中华皮肤科杂志, 2013, 46(12): 892-895.

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