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成人原发性免疫缺陷病患者静脉注射免疫球蛋白与皮下注射免疫球蛋白的比较研究:一项系统评价与荟萃分析

A Comparative Study of Intravenous Immunoglobulin and Subcutaneous Immunoglobulin in Adult Patients with Primary Immunodeficiency Diseases: A Systematic Review and Meta-Analysis.

作者信息

Shabaninejad Hosein, Asgharzadeh Asra, Rezaei Nima, Rezapoor Aziz

机构信息

a Department of Health Management, School of Health Management & Information Sciences , Iran University of Medical Sciences , Tehran , Iran.

b School of Health Management & Information Sciences , Iran University of Medical Sciences , Tehran , Iran.

出版信息

Expert Rev Clin Immunol. 2016;12(5):595-602. doi: 10.1586/1744666X.2016.1155452. Epub 2016 Mar 9.

Abstract

Subcutaneous immunoglobulin (SCIG) is a new therapeutic procedure for patients with primary immunodeficiency (PI). This research is a systematic review of studies on the efficacy and safety of intravenous immunoglobulin (IVIG) and SCIG in adult patients with PI. This study includes a systematic review of cohorts and randomized clinical trials (24 articles) from 5 databases with no time limits. Random effects meta-analysis was performed for outcomes such as efficacy and safety. Standard mean difference (SMD) of serum immunoglobulin level was equal to 0.336 (P <0.01; 0.205-0.467) and the odds ratio (OR) of side effects was 0.497 (P=0.1; 0.180-1.371). The results indicate that SCIG leads to a higher level of immunoglobulin and a reduction in side effects but shows the same infection rate as IVIG. Our analysis shows that shifting from IVIG to SCIG therapy can have clinical benefits for PI patients.

摘要

皮下注射免疫球蛋白(SCIG)是一种针对原发性免疫缺陷(PI)患者的新型治疗方法。本研究是对静脉注射免疫球蛋白(IVIG)和SCIG在成年PI患者中的疗效和安全性研究的系统评价。本研究包括对来自5个无时间限制数据库的队列研究和随机临床试验(24篇文章)的系统评价。对疗效和安全性等结局进行随机效应荟萃分析。血清免疫球蛋白水平的标准平均差(SMD)等于0.336(P<0.01;0.205 - 0.467),副作用的比值比(OR)为0.497(P = 0.1;0.180 - 1.371)。结果表明,SCIG可使免疫球蛋白水平升高,副作用减少,但感染率与IVIG相同。我们的分析表明,从IVIG治疗转向SCIG治疗对PI患者可能具有临床益处。

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