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Objective: Hepatitis B virus associated glomerulonephritis (Hepatitis B Virus-associated Glomerulonephritis, HBV-GN) is the most common secondary glomerular diseases, is one of the more common hepatitis B virus extrahepatic invasive disease. Its pathogenesis is not yet fully clear, the treatment program is not unified, traditional use of a therapeutic effect of the hormone and immunosuppressant although used alone may induce active replication of hepatitis B virus, most scholars have advocated as a first-line drugs, and anti-HBV drugs gradually being used to treat the disease. The purpose of this study is to antiviral Meta-analysis of the efficacy and safety of treatment of HBV-GN as reliable evidence to guide clinical practice, and to provide a scientific basis for future clinical application of antiviral drugs. Method: retrieve PubMed, EMBASE, the Cochrane Library, Ovid full-text database, Chinese Biomedical Literature Database, China Academic Journal Outstanding Dissertation full text database of China, to China academic conference papers, collection, English anti-virus HBV-GN Quality assessment, treatment (including interferon, lamivudine, adefovir dipivoxil, entecavir abacavir, etc.) literature, the application of the method recommended by the international Cochrane Centre screened qualified literature, Meta-analysis using RevMan 4.2 and STATA 10.1 software , urinary protein of the calculation of the treatment group and the control group response rate the serum HBeAg seroconversion rate, relative risk (RR) and its 95% CI, Meta-analysis of the data can not be descriptive analysis, systematic reviews of anti-viral treatment programs The efficacy and safety. Results: were detected in the English literature 1020, based on inclusion and exclusion criteria, the final five literature (4, 1 Chinese) included in the study, of which only one randomized controlled trials are cohort study . Three study treatment with recombinant human interferon-α (γIFN-α), a lamivudine therapy, and the other one to entecavir treatment. Included in 200 patients (antiviral treatment group, 105 patients in the control group to the symptomatic treatment of 95 cases). The clinical response (urinary protein mitigation) Meta-analysis: RR = 1.52,95% CI: 1.12 to 2.07, the anti-viral treatment group response rate of urinary protein (93%) higher than that of the control group (60%), the difference between the two groups of Statistics significance (P = 0.007); adult subgroup analysis showed that antiviral treatment of urinary protein response rate (96.7%) with the control group (63.6%) there is a statistically significant difference (P lt; 0.0001). Virologic response (serum HBeAg loss) Meta-analysis: RR = 3.68,95% CI: 1.35 to 10.05, HBeAg negative conversion rate of the anti-viral treatment group (63.9%) higher than that of the control group (16.48%), the two groups The difference was statistically significant (P = 0.01); the Adult Subgroup analyzes also reached the same conclusion. The chi-square test correlation analysis showed that serum HBeAg clearance and proteinuria remission was a positive correlation (correlation coefficient = 0.373, P lt; 0.01). In addition, the incidence of worsening renal function in the treatment group (5.5%) than the control group (20.9%) (P = 0.022). The conclusion: there are a variety of drugs for the treatment of HBV-GN is inconclusive, but by far the best treatment options. This study shows that antivirals (including γIFN-α, lamivudine, entecavir) in the treatment of HBV-GN can effectively alleviate proteinuria, serum HBeAg seroconversion rate, and delay the deterioration of renal function occurred to some extent, and HBeAg clearance and proteinuria remission was positively correlated well tolerated in most patients. Due to differences in treatment programs limited original research quality, quantity, and research, the conclusions for clinicians only reference definitive conclusions will be multi-center, large-scale randomized controlled trials for more high-quality evidence-based medicine The evaluation of the evidence of the system update.
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