吗替麦考酚酯联合激素治疗隐源性膜性肾小球肾炎的效果和安全性的meta分析

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Abstract Objective To systematically evaluate the efficacy and safety of Mycophenolate Mofetil combined with hormone in the treatment of cryptogenic membranous glomerulonephritis. Methods The literatures related to Mycophenolate Mofetil combined with hormone in the treatment of cryptogenic membranous glomerulonephritis were searched from CNKI, Wanfang Data, VIP, SinoMed, PubMed, Embase, and The Cochrane Library, the retrieval period was from the inception to March 2021. Literatures were screened and data were extracted by two researchers, and meta-analysis was performed using R 4.0.3. Results A total of 12 literatures were included, including 789 patients. The complete response rate (OR = 2.27, 95%CI: 1.49-3.45, P ＜ 0.05) and total response rate (OR = 1.90, 95%CI: 1.26-2.85, P ＜ 0.05) in the combined group were higher than those in the control group at six months, and the complete response rate (OR = 1.86, 95%CI: 1.14-3.03, P ＜ 0.05) and total response rate (OR = 1.95, 95%CI: 1.20-3.14, P ＜ 0.05) were higher than those in control group at 12 months. There was no significant difference in the incidence of adverse reactions between the combined group and the control group (OR = 0.57, 95%CI: 0.31-1.05, P ＞ 0.05). Albumin (SMD = -0.25, 95%CI: -1.00-0.51, P ＞ 0.05), serum creatinine (SMD = -0.01, 95%CI: -0.23-0.25, P ＞ 0.05), 24 h urinary protein (SMD = 0.09, 95%CI: -0.08-0.26, P ＞ 0.05) in the combined group at six months compared with the control group, the difference was not statistically significant. Albumin (SMD = 0.15, 95%CI: -0.08-0.38, P ＞ 0.05), serum creatinine (SMD = -0.02, 95%CI: -0.21-0.26, P ＞ 0.05), and 24h urine protein (SMD = -0.19, 95%CI: -0.42--0.04, P ＞ 0.05) in the combined group at 12 months compared with the control group, the difference was not statistically significant. The incidence of adverse reactions was P ＞ 0.05 by Egger and Begg test, and there was no publication bias. Conclusion The effect of Mycophenolate Mofetil combined with hormone in the treatment of cryptogenic membranous glomerulonephritis is better, which is worthy of further study and confirmation in clinic.

Key words： Cryptogenic membranous glomerulonephritis Mycophenolate Mofetil Glucocorticoid Meta analysis

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	JIANG Xinyu1 WANG Yu2 ZHANG Xiaofeng2 CHENG Xiaohong2

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JIANG Xinyu1 WANG Yu2 ZHANG Xiaofeng2 CHENG Xiaohong2. Meta-analysis of the clinical efficacy and safety of Mycophenolate Mofetil combined with hormone in the treatment of cryptogenic membranous glomerulonephritis#br#[J]. 中国医药导报, 2022, 19(12): 70-74.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I12/70

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