目的 系統(tǒng)評價鼠神經(jīng)生長因子（Mouse Nerve Growth Factor，mNGF）聯(lián)合常規(guī)藥物治療阿爾茨海默?。ˋlzheimer's disease，AD）的有效性和安全性。方法 計算機檢索PubMed、EMbase、The Cochrane Library、中國生物醫(yī)學文獻數(shù)據(jù)庫（CBM）、中國學術期刊全文數(shù)據(jù)庫（CNKI）、維普中文期刊全文數(shù)據(jù)庫（VIP）和萬方數(shù)據(jù)庫，搜集關于mNGF聯(lián)合常規(guī)藥物治療AD的隨機對照試驗（RCT），檢索時限均從數(shù)據(jù)庫建庫至2020年5月31日。依據(jù)納入和排除標準篩選文獻、質(zhì)量評價后采用Revman 5.3軟件進行Meta分析。結(jié)果 最終納入13個RCTs，共1 086例患者，其中mNGF組545例、對照組541例。與對照組比較，mNGF治療組能更有效地改善簡易智力狀態(tài)檢查量表評分（MD=2.29，95% CI=1.92~2.66，P<0.01）、臨床癡呆評定量表評分（MD=-0.36，95% CI=-0.45~-0.26，P<0.01）、日常生活活動能力量表評分（MD=3.53，95% CI=2.48~4.59，P<0.01）和臨床有效率（RR=1.29，95% CI=1.15~1.45，P<0.01）；C-反應蛋白（MD=-0.84，95% CI=-0.99~-0.70，P<0.01）、白細胞介素-6（MD=-3.13，95% CI=-3.73~-2.54，P<0.01）和腫瘤壞死因子-α（MD=-3.52，95% CI=-4.43~-2.61，P<0.01）水平更低；兩組不良反應發(fā)生率比較，差異無統(tǒng)計學意義（RR=1.09，95% CI=0.56~2.12，P=0.81）。結(jié)論 常規(guī)治療基礎上聯(lián)合mNGF可進一步改善AD患者的認知功能，降低癡呆程度，提高自主生活能力，提高臨床有效性，且沒有增加不良反應發(fā)生。

Objectives To systematically review efficacy and safety of mouse nerve growth factor (mNGF) with routine treatment for Alzheimer's disease (AD). Methods Databases including PubMed, EMbase, The Cochrane Library, CNKI, VIP, CBM and Wanfang Data were electronically searched from database up to 31 May 2020 to collect randomized controlled trials of mNGF with routine treatment for AD. The trial was screened based on inclusion and exclusion criteria, and the methodological quality of the included trial was assessed. Meta-analysis was performed by Revman 5.3 software. Results A total of 13 studies involving 1 086 patients were included. The mNGF group included 545 patients and the control group included 541 patients. The result of Metaanalysis showed that, compared with the use of only routine treatment the combination of mNGF can improve score of mini-mental state examination (MD=2.29, 95%CI=1.92 to 2.66, P<0.01), score of clinical dementia rating (MD=-0.36, 95%CI=-0.45 to -0.26, P<0.01), score of activity of daily living (MD=3.53, 95%CI=2.48 to 4.59, P<0.01) and clinical response rate (RR=1.29, 95%CI=1.15 to 1.45,P<0.01); lower the value of C-reactive protein (MD=-0.84, 95%CI=-0.99 to -0.70, P<0.01), IL-6 (MD=-3.13, 95%CI=-3.73 to -2.54, P<0.01) and TNF-α (MD=-3.52, 95%CI=-4.43 to -2.61, P<0.01). There was no significant difference in number of adverse events between the mNGF group and the control group (RR=1.09, 95%CI=0.56 to 2.12, P=0.81). Conclusion mNGF combined with routine therapy can improve the cognitive function of AD patients, reduce the degree of dementia, improve the ability of independent living, improve the clinical efficacy, and does not increase the incidence of adverse reactions.

R971

甘肅省高等學校創(chuàng)新能力提升項目（2019B-198）