重新审视螺旋霉素预防被忽视疾病的作用：观察性研究的荟萃分析。
A fresh look at the role of spiramycin in preventing a neglected disease: meta-analyses of observational studies.
机构信息
Jack S. Remington Laboratory for Specialty Diagnostics, Palo Alto, CA, USA.
Antios Therapeutics, Mendham, NJ, USA.
出版信息
Eur J Med Res. 2021 Dec 11;26(1):143. doi: 10.1186/s40001-021-00606-7.
PURPOSE
We aimed to investigate the effect of antepartum treatment with spiramycin with or without subsequent pyrimethamine-sulfonamide-folinic acid, compared to no treatment, on the rate of mother-to-child transmission (MTCT) of Toxoplasma gondii (T. gondii) and incidence/severity of sequelae in the offspring.
METHODS
Embase and PubMed were searched for literature on spiramycin in pregnant women suspected/diagnosed with T. gondii infection. Meta-analyses were performed using random-effects model.
RESULTS
Thirty-three studies (32 cohorts and 1 cross-sectional study), with a total of 15,406 mothers and 15,250 offspring, were pooled for analyses. The MTCT rate for all treated patients was significantly lower than the untreated [19.5% (95% CI 14-25.5%) versus 50.7% (95% CI 31.2-70%), p < 0.001]. The transmission rate in patients on spiramycin monotherapy was also significantly lower than untreated [17.6% (95% CI 9.9-26.8%) versus 50.7% (95% CI 31.2-70%), p < 0.001].
CONCLUSION
Results indicate significant reduction in MTCT rates following spiramycin treatment of suspected/diagnosed maternal T. gondii infection.
目的
我们旨在研究与未治疗相比，在疑似/诊断为弓形体病感染的孕妇中进行螺旋霉素产前治疗，以及随后是否使用乙胺嘧啶-磺胺嘧啶-亚叶酸治疗，对母婴传播（MTCT）率和后代后遗症的发生率/严重程度的影响。
方法
通过 Embase 和 PubMed 搜索有关孕妇疑似/诊断为弓形体病感染时使用螺旋霉素的文献。使用随机效应模型进行荟萃分析。
结果
共纳入 33 项研究（32 项队列研究和 1 项横断面研究），共 15406 名母亲和 15250 名子女。所有治疗患者的 MTCT 率明显低于未治疗组[19.5%（95%CI 14-25.5%）比 50.7%（95%CI 31.2-70%），p<0.001]。螺旋霉素单药治疗患者的传播率也明显低于未治疗组[17.6%（95%CI 9.9-26.8%）比 50.7%（95%CI 31.2-70%），p<0.001]。
结论
结果表明，在疑似/诊断为母体弓形体病感染的孕妇中，使用螺旋霉素治疗可显著降低 MTCT 率。
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