奥马珠单抗治疗变应性肺曲霉病临床疗效的Meta分析

Clinical Efficacy of Omalizumab in the Treatment of Allergic Pulmonary Aspergillosis: A Meta-Analysis

摘要: 目的：评价奥马珠单抗治疗变应性肺曲霉病的临床疗效。方法：用计算机检索CHKI、PubMed、Embase、中华医学期刊全文数据库、万方等数据库，筛选奥马珠单抗治疗变应性肺曲霉病的相关文献，检索时间从建库起至2022年4月，最后采用RevMan15.4软件进行Meta分析。结果：纳入24篇文献进行Meta分析，Meta分析结果表明：应用奥马珠单抗后，嗜酸性粒细胞(MD = −2.85, 95% CI = −5.34~−0.37)、血清中总IgE (MD = −296.62, 95% CI = −481.09~−112.15)以及烟曲霉特异性IgE (MD = −6.00, 95% CI = −6.89~−5.11)的水平较前降低，FEV₁ (MD = −7.93, 95% CI = −4.33~−11.53)水平较前升高。结论：奥马珠单抗可以减轻变应性肺曲霉病患者血清中嗜酸性粒细胞、血清中总IgE以及烟曲霉特异性IgE的水平，升高FEV₁的水平，具有一定的临床疗效，但未来仍需要更多、高质量的随机对照实验进一步研究证实。

Abstract: Objective: To evaluate the clinical efficacy of omalizumab in the treatment of allergic pulmonary aspergillosis. Methods: CHKI, PubMed, Embase, Chinese Medical Journal Full-text Database, Wan-fang and other databases were searched by computer to screen the relevant literature on omi-zumab in the treatment of allergic pulmonary aspergillosis from the establishment of the database to April 2022. Finally, RevMan15.4 software was used for meta-analysis. Results: 24 articles were included for meta-analysis, and the results showed that: after omizumab administration, eosino-phils (MD = −2.85, 95% CI = −5.34 to −0.37), serum total IgE (MD = −296.62, 95% CI = −481.09 to −112.15) and Aspergillus fumigatus specific IgE (MD = −6.00, 95% CI = −6.89 to −5.11) were de-creased, and the level of FEV₁ (MD = −7.93, 95% CI = −4.33~11.53) was increased. Conclusion: Omizumab can reduce the levels of eosinophils, total IgE and Aspergillus fumigatus specific IgE in serum of patients with allergic pulmonary aspergillosis, and increase the level of FEV₁, which has a certain clinical effect. However, more high-quality randomized controlled trials are still needed to further study and confirm in the future.