糖皮质激素在儿童支原体肺炎治疗中的作用的系统评价分析
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摘要
目的:系统评价糖皮质激素在儿童支原体肺炎治疗中的作用。方法:计算机检索中英文数据库,依据纳入指标及排除指标纳入文献,根据Jadad评分及偏倚分析对文献进行评价,运用Revman5.0进行系统评价。结果:糖皮质激素对儿童支原体肺炎患者的体温及CRP调节具有特异质,进行随机效应模型评价,结果分别为-1.4及-0.42,P<0.05,具有统计学意义。亚组分析氢化可的松、甲泼尼松龙及地塞米松对体温的调节结果均有显著性差异,氢化可的松效果最好;结论:糖皮质激素在儿童支原体肺炎治疗中对体温和CRP的调节有积极的意义。
Objective: To evaluate the effect of glucocorticosteroid on children mycoplasmal pneumonia. Methods: Meta-analysis was performed by evaluating 19 controlled trials of the effect of glucocorticosteroid on children mycoplasmal pneumonia. Results: The results of pooled effects of glucocorticosteroid on body temperature and CRP control were-1.4 and-0.42 respectively, which showed significant difference. Conclusion: Glucocorticosteroid has a significant effect on children mycoplasmal pneumonia in body temperature and CRP control.
Objective: To evaluate the effect of glucocorticosteroid on children mycoplasmal pneumonia. Methods: Meta-analysis was performed by evaluating 19 controlled trials of the effect of glucocorticosteroid on children mycoplasmal pneumonia. Results: The results of pooled effects of glucocorticosteroid on body temperature and CRP control were-1.4 and-0.42 respectively, which showed significant difference. Conclusion: Glucocorticosteroid has a significant effect on children mycoplasmal pneumonia in body temperature and CRP control.
引文
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[23]张兆兰.抗生素+糖皮质激素治疗难治性肺炎支原体肺炎疗效观察[J].临床荟萃,2011,26(21):1906-1907.
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[26]侯安存,卢炎,沙莉,等.支原体肺炎患儿辅助性T淋巴细胞亚群Th1、Th2细胞状况[J].中华儿科杂志,2003,41(9):252.
[27]Tagliabue G,Salvatore C.The Impact of Steroids Given with Macrolide Therapy in Experimental Mycoplasma Pneumoniae Respiratory Infection[J].J Infect Dis,2008,15,198(8):1180-1188.
[28]黄颖.糖皮质激素类药物在临床中的合理应用[J].中外健康文摘,2009,6(14):44.
[29]张祖莲.阿奇霉素治疗小儿支原体肺炎的疗效和安全性,临床药物治疗杂志,2011,9(5):29-30.
[30]张海英,李玉珍.糖皮质激素类药物的药理特性及合理应用,临床药物治疗杂志,2004,2(3):36-42.
[31]赵籥陶,黄慈波.糖皮质激素的合理使用[J].临床药物治疗杂志,2011,8(1),23-28.
[2]Tagliabue C,Salvatore C M.The Impact of Steroids Given with Macrolide Therapy in Experimental Mycoplasma pneumoniae Respiratory Infection[J].J Infect Dis,2008,15;198(8):1180-1188.
[3]刘长青.糖皮质激素辅助治疗小儿肺炎支原体肺炎的临床分析[J].吉林医学,2012,33(5):958-959.
[4]中华医学会儿科学分会呼吸学组.儿童社区获得性肺炎管理指南,[J].中华儿科杂志,2013,10,51(10):745-752.
[5]董伟然.儿童难治性支原体肺炎的临床特点分析及甲泼尼松龙的治疗作用研究[D].石家庄:河北医科大学,2013.
[6]曾宪涛,包翠萍.Meta分析系列之三:随机对照试验的质量评价工具[J].中国循证心血管医学杂志,2012,4(3):183-184.
[7]陈进.短期小剂量糖皮质激素治疗儿童支原体肺炎的疗效观察[J].中国医疗前沿,2013,8(17):59-60.
[8]陈真堂.短期小剂量糖皮质激素联合阿奇霉素治疗儿童支原体肺炎临床分析[J].内蒙古中医药,2010,10(20):114-115.
[9]丁荣泉.抗生素联合糖皮质激素治疗小儿支原体肺炎的疗效观察[J].中外医学研究,2012,10(5):129.
[10]唐双意,刘滔滔,钟小斌.某“三甲”医院2009年1-6月糖皮质激素应用分析[J].中国药房,2011,22(14):1258-1261.
[11]高大明,翟爱国.小剂量激素短疗程辅助治疗支原体肺炎临床观察[J].安徽医药,2010,14(6):713-714.
[12]黄冬娥,陈小燕.短期应用低剂量糖皮质激素佐治儿童支原体肺炎临床观察[J].中国民族民间医药,2013:77.
[13]李劲松,张利.联合方案治疗儿童重症支原体肺炎临床疗效评价[J].安徽医药,2011,15(6):752-753.
[14]刘阳.阿奇霉素联合地塞米松治疗儿童重症支原体肺炎的疗效分析[J].中国民康医学,26(19):46-47.
[15]Lizhen H,Early G,Treatment with Corticosteroids in Patients with Mycoplasma pneumoniae pneumonia:A Randomized Clinical Trial[J].J Tropical Pediatrics,2014,60(5):338-342.
[16]唐春梅.糖皮质激素在支原体肺炎的疗效[J].求医问药,2011,9(9):273-274.
[17]王丹霞.小剂量糖皮质激素在儿童支原体肺炎中应用疗效研究[J].中外医学研究,2011,9(29):30-31.
[18]王伏东,高惠峰.红霉素和糖皮质激素联合治疗持续高热的肺炎支原体肺炎的疗效[J].药物与临床,2011,8(18):82-84.
[19]王颖,朱彦宣,张辛兰.小儿支原体肺炎短期应用小剂量糖皮质激素的临床观察[J].中国妇幼保健,2013,34(23):4924-4925.
[20]吴跃进,孙节.糖皮质激素辅助治疗儿童肺炎支原体大叶性肺炎的疗效[J].中国当代儿科杂志,2014,16(4):401-405.
[21]Youn Y S,Lee S C.Early Additional Immune-Modulators for Mycoplasma pneumoniae Pneumonia in Children:An Observation Study[J].Infect Chemother,2014,46(4):239-247.
[22]张清友,王秀丽.儿童重症肺炎支原体肺炎临床特征及激素治疗疗效分析[J].中国实用儿童科杂志,2011,26(3):223-224.
[23]张兆兰.抗生素+糖皮质激素治疗难治性肺炎支原体肺炎疗效观察[J].临床荟萃,2011,26(21):1906-1907.
[24]郑改平.糖皮质激素用于小儿肺炎支原体肺炎的疗效观察[J].中国社区医师,2012,17(14):40.
[25]Xiu L Z,Jian L.Effects of Prednisolone on Refractory Mycoplasma Pneumoniae Pneumonia in Children[J].Pediat Pulmonol,2014,4(9):377-380.
[26]侯安存,卢炎,沙莉,等.支原体肺炎患儿辅助性T淋巴细胞亚群Th1、Th2细胞状况[J].中华儿科杂志,2003,41(9):252.
[27]Tagliabue G,Salvatore C.The Impact of Steroids Given with Macrolide Therapy in Experimental Mycoplasma Pneumoniae Respiratory Infection[J].J Infect Dis,2008,15,198(8):1180-1188.
[28]黄颖.糖皮质激素类药物在临床中的合理应用[J].中外健康文摘,2009,6(14):44.
[29]张祖莲.阿奇霉素治疗小儿支原体肺炎的疗效和安全性,临床药物治疗杂志,2011,9(5):29-30.
[30]张海英,李玉珍.糖皮质激素类药物的药理特性及合理应用,临床药物治疗杂志,2004,2(3):36-42.
[31]赵籥陶,黄慈波.糖皮质激素的合理使用[J].临床药物治疗杂志,2011,8(1),23-28.