关键词: 肾炎, 乙型肝炎病毒, 免疫抑制剂, Meta分析

Abstract: Objective  To evaluate the efficacy and safety of immunosuppressant combined with nucleoside analogues therapy in adult hepatitis B virusassociated glomerulonephritis (HBVGN) patients. Methods  We searched the Cochrane Library， PubMed， Embase， SCI， Chinese BioMedical database， CNKI， VIP and Wanfang of Database from Jan  1，2009 to  Dec 31，2016 to screen the clinical trials of immunosuppressant combined with nucleoside analogues therapy in adult HBVGN patients. Two researchers critically screened literatures by incorporating and exclusion criteria， extracted relevant data，then independently assessed by methodological quality. Rev Man 5.3 software was used for metaanalysis. Results  A total of 13 cohort studies involving 606 adult HBVGN patients were  finally included. The results of metaanalysis showed that the combining therapy group was better than the control group in reducing 24 hour urinary protein quantity;the combining therapy group was better than the control group in increasing serum albumin， the complete remission rate and the objective response rate; the two groups showed no significant difference in alanine aminotransferase and negative conversion ratio of HBVDNA. Conclusion  Compared with single nucleoside analogues therapy， immunosuppressant combined with nucleoside analogues therapy can increase the objective response rate and complete remission rate， more effectively reduce 24 hours urinary protein quantity and protect hepatorenal  function，keep  hepatic  function  intact and no replication of HBVDNA in adult HBVGN patients.

Key words: nephritis, hepatitis B virus；immunosuppressant, metaanalysis