Meta-analysis On The Protection Of Montelukast For The Kidneys Of The Children With Henoch-sch?nlein Purpura

Objective:By means of Meta analysis, this research evaluates the protection of montelukast for the kidneys of the children with henoch-sch?nlein purpura,in order to provide evidence for further prevention and mitigation of henoch-sch?nlein purpura nephritis in children.Methods : Searched Chinese databases, including China National Knowledge Internet(CNKI), China Biomedical Literature Database(CBM), VIP Chinese periodical database and Wanfang database. Searched foreign language database, including PubMed, Cochrane Library, EMBASE, MEDLINE. Collect the literatures about the therapy of henoch-sch?nlein purpura with Montelukast comprehensively.Formulate standard of incorporating and excluding literatures, according to the screen and evaluation made by two researchers, carry out quality evaluation on the incorporated literature based on Cochrane Handbook 5.1.0 risk bias assessment. Conduct Meta analysis on the data extracted from all the literatures met the standards by using RevMan5.3 software system.Results:It searched 353 literatures in total, among which 351 are Chinese literatures while 2 are English literatures, and 11 literatures were incorporated into the Meta analysis. Hereinto, Sheng-HuaWu adopted the method of correct randomized controlled grouping, distribution concealing, blind experiment, no exit and lost follow-up, no-choice report, and other bias. Meanwhile, the other 10 literatures adopted randomized controlled method, no exit and lost follow-up, no-choice report, and other bias, but some did not mention distribution concealing or blind experiment. The overall literature baseline information has comparability, which is stable when carrying out sensitivity analysis.Meta-analysis showed: Montelukast observation group total effective rate was 90.7%(196/216),the total effective rate was 74.4%(154/207) in the control group, the two groups was statistically significant [RR = 1.22(95%CI:1.11,1.33), P<0.0001]. Other indexes, except for the urinary LTE4 [SMD =-0.86(95%CI:-2.14,0.42),P=0.19], there was no statistically significant difference, urinary TRF [SMD =-0.75(95%CI:-1.15,-0.34)],urinary β2-MG [SMD =-1.58(95%CI:-1.98,-1.18)], serum β2-MG [SMD =-7.22(95%CI:-8.12,-6.31)]、urinary IgG [SMD = =-1.02(95%CI:-1.31,-0.73)], urinary Alb [SMD =-1.49(95%CI:-2.20,-0.79)], urinaryα1-MG[SMD=-0.35,(95%CI:-0.59,-0.11)], all P < 0.05, Sensitivity analysis of the total efficiency, the results are basically stable.Conclusion:The existing evidence proved that, the application of Montelukast to children with HSP based on conventional treatment can relieve the occurrence of renal injury to some extent with slight adverse reaction, so as to prevent and reduce HSPN. however, it still need to be confirmed by the high quality test with large samples as well as multiple centers.