高剂量甲状腺素尿液化的口服治疗方案:系统性审查和元分析
Romina Kaveh-Ahangaran1, Mohammad Abdollahi2,3, Mohammad Vaezi1
1Hematology, Oncology, and Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology, and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran.
口服二碳酸盐有效地化尿对于高剂量甲醇 (HDMTX) 患者,为IV二碳酸提供安全的替代品. 这种方法在药物短缺和门诊护理期间至关重要.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 高剂量甲索特雷克萨特 (HDMTX) 治疗需要尿液化以防止脏损伤 (毒性).
- 静脉注射 (IV) 碳酸是标准的,但药物短缺和门诊需求凸显了替代方法的重要性.
- 口服二碳酸盐疗法在HDMTX治疗期间提供了维持适当尿液pH值的潜在解决方案.
研究的目的:
- 在接受HDMTX的患者中,系统地审查口服二碳酸盐治疗方案对尿液化的疗效和安全性.
- 评估口服二碳酸盐作为IV二碳酸的可行替代品.
- 评估口服二碳酸盐对尿液pH和相关不良事件的影响.
主要方法:
- 在PubMed,WOS和Scopus中按照PRISMA指南进行了系统的文献搜索.
- 包括的研究包括随机临床试验,回顾性,前性,队列,病例报告和病例系列.
- 提取了关于疗效和安全性的数据,并使用ROBINS-I工具评估了研究质量.
主要成果:
- 包括1212名参与者的12项研究;元分析使用了8项研究的数据.
- 与标准疗法相比,口服二碳酸盐的疗效没有显著差异,除了腹发病率较高 (OR:2.92).
- 当pH值低于7时,观察到尿液pH值下降的趋势 (MD:0.91).
结论:
- 口服二碳酸盐是接受HDMTX的患者尿液化的安全有效替代品.
- 这种方案提供了一个可行的,具有成本效益的选择,特别有利于在IV二碳酸短缺期间和门诊管理.
- 建议进行进一步的前性多中心研究,以巩固这些发现.
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