多纳酶阿尔法治疗囊性纤维化。
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琼斯AP，沃利斯C
多纳酶阿尔法治疗囊性纤维化。
Cochrane Database Syst Rev. 2010 3月17日;(3):CD001127。cd001127.pub2 doi: 10.1002/14651858.。
- PubMed ID
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20238314 (PubMed视图］
- 摘要
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背景:Dornase alfa目前用于治疗囊性纤维化的肺部疾病(发病和死亡的主要原因)。目的:确定与安慰剂或其他粘液溶解剂相比，在囊性纤维化中使用dornase alfa是否与改善死亡率和发病率相关，并确定与其使用相关的任何不良事件。必威国际app检索策略:我们检索了Cochrane囊性纤维化和遗传疾病组试验登记册，其中包括从综合电子数据库检索、手工检索相关期刊和会议摘要中确定的参考文献。该集团囊性纤维化登记册的最近搜索日期:2009年必威国际app7月17日。选择标准:所有将dornase alfa与安慰剂、标准疗法或另一种粘液溶解剂进行比较的随机和准随机对照试验。数据收集和分析:作者独立评估了纳入标准的试验;第一作者和一位同事对方法学质量和数据提取进行了分析。主要结果:检索确定了43个试验，其中必威国际app15个符合我们的纳入标准，包括总共2469名参与者。另外三项研究检查了其中一项临床试验的医疗成本。12项研究比较了dornase alfa与安慰剂或无dornase alfa治疗;一个比较了每日睡眠酶阿尔法与高渗盐水和隔日睡眠酶阿尔法; and two compared daily dornase alfa to hypertonic saline. Study duration varied from six days to two years. The number of deaths was not significant between treatment groups. Spirometric lung function improved in the treated groups, with significant differences at one month, three months, six months and two years, there was a non-significant difference at three years. There was no excess of adverse effects except voice alteration and rash, which were reported more frequently in one trial in the treated groups. Insufficient data were available to analyse differences in antibiotic treatment, inpatient stay and quality of life. AUTHORS' CONCLUSIONS: There is evidence to show that therapy with dornase alfa over a one-month period is associated with an improvement in lung function in CF; results from a trial lasting six months also showed the same effect. Therapy over a two-year period (based on one trial) significantly improved FEV(1) in children and there was a non-significant reduction in the risk of infective exacerbations. Voice alteration and rash appear to be the only adverse events reported with increased frequency in randomised controlled trials.
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