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Abstract：
OBJECTIVE: To evaluate the efficacy of urokinase (UK) treatment for tuberculous pleural effusion (TPE).
METHODS: We searched Chinese biomedical literature database, WanFang data, CNKI, PubMed, EMbase, Web of Science and The Cochrane Library for the randomized controlled trials (RCTs) of urokinase treatment for tuberculous pleurisy from January 2000 to February 2023. Pleural tuberculosis, urokinase and randomized controlled trial were used as keywords. The eligible studies were meta-analyzed by using Revman 5.4.1: risk of bias was assessed, mean difference (MD) and 95% CI were used for continuous variables, pooled studies were conducted using random-effects or fixed-effects models, forest plots were drawn to analyze efficacy, and funnel plots were drawn to discuss publication bias.
RESULTS: Twenty-nine RCTs were included. The meta-analyzed results showed that, on the basis of routine anti-tuberculosis, comparison between the treatment group treated with urokinase and the control group treated with antituberculosis alone, the time of pleural effusion absorption [MD-5.82, 95%CI (- 7.77, - 3.87); P<0.00001] and the residual pleural thickness [MD-1.31, 95%CI (- 1.70, - 0.91); P<0.00001], pleural effusion drainage volume [MD 822.81, 95%CI (666.46,977.96); P<0.00001], FVC%pred [MD 7.95, 95%CI (4.51,11.40); P<0.00001], FEV1%pred [MD 12.67, 95%CI (10.09,15.24); P<0.00001] were significantly different.
CONCLUSIONS: The clinical effect of urokinase is better than that of antituberculous therapy alone: it can increase total pleural effusion, decrease residual pleural thickness, improve the pulmonary function, and shorten the time of pleural effusion absorption.
METHODS: We searched Chinese biomedical literature database, WanFang data, CNKI, PubMed, EMbase, Web of Science and The Cochrane Library for the randomized controlled trials (RCTs) of urokinase treatment for tuberculous pleurisy from January 2000 to February 2023. Pleural tuberculosis, urokinase and randomized controlled trial were used as keywords. The eligible studies were meta-analyzed by using Revman 5.4.1: risk of bias was assessed, mean difference (MD) and 95% CI were used for continuous variables, pooled studies were conducted using random-effects or fixed-effects models, forest plots were drawn to analyze efficacy, and funnel plots were drawn to discuss publication bias.
RESULTS: Twenty-nine RCTs were included. The meta-analyzed results showed that, on the basis of routine anti-tuberculosis, comparison between the treatment group treated with urokinase and the control group treated with antituberculosis alone, the time of pleural effusion absorption [MD-5.82, 95%CI (- 7.77, - 3.87); P<0.00001] and the residual pleural thickness [MD-1.31, 95%CI (- 1.70, - 0.91); P<0.00001], pleural effusion drainage volume [MD 822.81, 95%CI (666.46,977.96); P<0.00001], FVC%pred [MD 7.95, 95%CI (4.51,11.40); P<0.00001], FEV1%pred [MD 12.67, 95%CI (10.09,15.24); P<0.00001] were significantly different.
CONCLUSIONS: The clinical effect of urokinase is better than that of antituberculous therapy alone: it can increase total pleural effusion, decrease residual pleural thickness, improve the pulmonary function, and shorten the time of pleural effusion absorption.
摘要：
目的：评价尿激酶(UK)治疗结核性胸腔积液(TPE)的疗效。
方法：我们检索了中国生物医学文献数据库，万方数据，CNKI,PubMed,EMBase,2000年1月至2023年2月尿激酶治疗结核性胸膜炎的随机对照试验（RCT）的WebofScience和Cochrane图书馆。胸膜结核,以尿激酶和随机对照试验为关键词.使用Revman5.4.1对符合条件的研究进行荟萃分析：评估偏倚风险，平均差(MD)和95%CI用于连续变量，使用随机效应或固定效应模型进行汇总研究，绘制了森林地块来分析功效，并绘制漏斗图讨论发表偏倚。
结果：纳入29项随机对照试验。荟萃分析结果显示,在常规抗结核的基础上，尿激酶治疗组与单纯抗结核治疗的对照组比较,胸腔积液吸收时间[MD-5.82,95CI(-7.77,-3.87);P<0.00001]和残余胸膜厚度[MD-1.31,95CI(-1.70,-0.91);P<0.00001],胸腔积液引流量[MD822.81,95CI(666.46,977.96);P<0.00001],FVC%pred[MD7.95,95CI(4.51,11.40);P<0.00001],FEV1%pred[MD12.67,95CI(10.09,15.24);P<0.00001]差异显著。
结论：尿激酶的临床疗效优于单纯抗结核治疗：可增加胸腔积液总量。减少残余胸膜厚度，改善肺功能，缩短胸腔积液吸收时间。
方法：我们检索了中国生物医学文献数据库，万方数据，CNKI,PubMed,EMBase,2000年1月至2023年2月尿激酶治疗结核性胸膜炎的随机对照试验（RCT）的WebofScience和Cochrane图书馆。胸膜结核,以尿激酶和随机对照试验为关键词.使用Revman5.4.1对符合条件的研究进行荟萃分析：评估偏倚风险，平均差(MD)和95%CI用于连续变量，使用随机效应或固定效应模型进行汇总研究，绘制了森林地块来分析功效，并绘制漏斗图讨论发表偏倚。
结果：纳入29项随机对照试验。荟萃分析结果显示,在常规抗结核的基础上，尿激酶治疗组与单纯抗结核治疗的对照组比较,胸腔积液吸收时间[MD-5.82,95CI(-7.77,-3.87);P<0.00001]和残余胸膜厚度[MD-1.31,95CI(-1.70,-0.91);P<0.00001],胸腔积液引流量[MD822.81,95CI(666.46,977.96);P<0.00001],FVC%pred[MD7.95,95CI(4.51,11.40);P<0.00001],FEV1%pred[MD12.67,95CI(10.09,15.24);P<0.00001]差异显著。
结论：尿激酶的临床疗效优于单纯抗结核治疗：可增加胸腔积液总量。减少残余胸膜厚度，改善肺功能，缩短胸腔积液吸收时间。
