阿奇霉素对环孢素诱导的牙龈增生的疗效：系统评价与荟萃分析。
The efficacy of azithromycin on cyclosporine-induced gingival enlargement: Systematic review and meta-analysis.
作者信息
Teshome Amare, Girma Biruk, Aniley Zelallem
机构信息
Department of Dentistry, School of Medicine, College of Medicine and Health Science, University of Gondar, Ethiopia.
Oral and Maxillofacial Surgery, Department of Dentistry, School of Medicine, College of Medicine and Health Science, University of Gondar, Ethiopia.
出版信息
J Oral Biol Craniofac Res. 2020 Apr-Jun;10(2):214-219. doi: 10.1016/j.jobcr.2019.12.005. Epub 2020 Jan 3.
BACKGROUND
Cyclosporine is one of the powerful immunosuppressant drugs commonly used to avoid transplant rejection and autoimmune condition management. However, this drug has many side effects, such as nephrotoxicity, hepatotoxicity, hypertension, and gingival overgrowth. Gingival enlargement is one of the most commonly reported adverse drug outcome in patients with long term usage of the drug with the exclusion of other confounding factors. Hence, this systematic review and Meta-analysis was planned to investigate the effect of azithromycin on cyclosporine A-induced gingival enlargement.
METHODS
We used 4 electronic databases: MEDLINE (up to January 2018), EMBASE (up to January 2018), CINAHL (up to January 2018), Cochrane Library (up to January 2018) to search all the available literature between February 1, 2018, and January 1, 2019. All papers, published up to January 2018, on the efficacy of azithromycin on cyclosporine-induced gingival enlargement were included on this systematic review and meta-analysis. RevMan 5.3 software was used to make the quantitative analysis and the pooled effect presented in terms of the mean difference. Meanwhile, the presence of heterogeneity is presented in terms of I.
RESULTS
Five Randomized controlled trials with a total of 167 participants were eligible for this study. The effect of azithromycin on cyclosporine-induced gingival growth, probing depth and plaque index was reported in 3 studies and the selected 5 studies reported its effect on bleeding on probing. The pooled effect revealed there was a significant reduction of gingival enlargement (MD, 1.58, 95%CI: 0.77-2.39) and bleeding on probing in the intervention group (MD, 1.32, 95%CI: 0.39-2.24). Statistically non-significant effects were observed on the effect of azithromycin on plaque index and probing depth in patients with cyclosporine-induced gingival enlargement.
CONCLUSION
Azithromycin has a clinically significant effect on the reduction of cyclosporine-induced gingival enlargement and bleeding on probing.
背景
环孢素是常用的强效免疫抑制药物之一，用于预防移植排斥反应和管理自身免疫性疾病。然而，这种药物有许多副作用，如肾毒性、肝毒性、高血压和牙龈增生。牙龈增生是长期使用该药物且排除其他混杂因素的患者中最常报告的药物不良反应之一。因此，本系统评价和荟萃分析旨在研究阿奇霉素对环孢素A诱导的牙龈增生的影响。
方法
我们使用了4个电子数据库：MEDLINE（截至2018年1月）、EMBASE（截至2018年1月）、CINAHL（截至2018年1月）、Cochrane图书馆（截至2018年1月），检索2018年2月1日至2019年1月1日期间所有可用的文献。所有截至2018年1月发表的关于阿奇霉素对环孢素诱导的牙龈增生疗效的论文均纳入本系统评价和荟萃分析。使用RevMan 5.3软件进行定量分析，并以平均差表示合并效应。同时，异质性以I²表示。
结果
五项随机对照试验共167名参与者符合本研究条件。三项研究报告了阿奇霉素对环孢素诱导牙龈生长、探诊深度和菌斑指数的影响，所选的五项研究报告了其对探诊出血的影响。合并效应显示，干预组牙龈增生（平均差，1.58，95%置信区间：0.77 - 2.39）和探诊出血（平均差，1.32，95%置信区间：0.39 - 2.24）显著减少。在环孢素诱导的牙龈增生患者中，未观察到阿奇霉素对菌斑指数和探诊深度的影响有统计学意义。
结论
阿奇霉素对减少环孢素诱导的牙龈增生和探诊出血具有临床显著效果。
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