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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.

DOI:10.1186/s40001-021-00606-7
PMID:34895348
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8665510/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87bc/8665510/11a5a95291ab/40001_2021_606_Fig2a_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87bc/8665510/639e0397c88d/40001_2021_606_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87bc/8665510/11a5a95291ab/40001_2021_606_Fig2a_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87bc/8665510/639e0397c88d/40001_2021_606_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87bc/8665510/11a5a95291ab/40001_2021_606_Fig2a_HTML.jpg

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