注射用阿奇霉素治疗小儿支原体肺炎疗效与安全性的系统评价
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篇名: 注射用阿奇霉素治疗小儿支原体肺炎疗效与安全性的系统评价
TITLE:
摘要: 目的:系统评价注射用阿奇霉素治疗小儿支原体肺炎的疗效与安全性,为其临床应用提供循证依据。方法:计算机检索中国知网、万方数据库、中国生物医学文献数据库、PubMed、Embase、Cochrane图书馆,纳入注射用阿奇霉素(试验组)对比其他药物(对照组)治疗小儿支原体肺炎的随机对照试验(RCT),提取资料并按Cochrane系统评价员手册 5.2.0评价质量后,采用 Rev Man 5.3统计软件进行 Meta分析。结果:最终纳入20项RCT,包括1 793例患儿,对照组均采用红霉素进行治疗。Meta分析结果显示,试验组患儿的总有效率[RR=1.13,95%CI(1.06,1.20),P<0.001]、退热时间[MD=-1.03,95%CI(-1.43,-0.64),P<0.001]、咳嗽好转时间[MD=-2.34,95%CI(-3.13,-1.55),P<0.001]、肺部啰音消失时间[MD=-2.54,95%CI(-4.37,-0.70),P=0.007]、胸片阴影吸收时间[MD=-1.76,95%CI(-3.43,-0.09),P=0.04]、住院时间[MD=-2.72,95%CI(-3.50,-1.94),P<0.001]均优于对照组;且总不良反应发生率[RR=0.39,95%CI(0.31,0.49),P<0.001]、胃肠道反应发生率[RR=0.36,95%CI(0.28,0.47),P<0.001]、肝脏毒性发生率[RR=0.55,95%CI(0.34,0.89),P=0.01]、输液反应发生率[RR=0.31,95%CI(0.20,0.48),P<0.001]、皮疹发生率[RR=0.34,95%CI(0.20,0.59),P<0.001]、腹痛发生率[RR=0.21,95%CI(0.09,0.49),P<0.001]等均显著低于对照组。结论:注射用阿奇霉素用于治疗小儿支原体肺炎具有良好的疗效与安全性。
ABSTRACT: OBJECTIVE: To evaluate the efficacy and safety of Azithromycin for injection in the treatment of mycoplasma pneumonia in children, and to provide evidence-based reference for clinical use. METHODS: Retrieved from CNKI, Wanfang database, CBM, PubMed, Embase and Cochrane Library,randomized controlled trials (RCTs) about Azithromycin for injection (trial group) versus other positive drugs (control group) in the treatment of mycoplasma pneumonia in children were collected. Meta-analysis was conducted by using Rev Man 5.3 statistical software after data extraction and quality evaluation with Cochrane system evaluator manual 5.2.0. RESULTS: A total of 20 RCTs were included finally, involving 1 793 children with mycoplasma pneumonia. Control groups were treated with erythromycin. Results of Meta-analysis showed that the total response rate [RR=1.13, 95%CI (1.06,1.20),P<0.001], defervescence time [RR=-1.03, 95%CI(-1.43, -0.64), P<0.001],cough time [MD=       -2.34, 95%CI(-3.13,-1.55), P<0.001], time of lung rale disappearance [MD=-2.54, 95%CI(-4.37, -0.70),P=0.007], time of chest shadow disappearance [MD=-1.76, 95%CI(-3.43, -0.09), P=0.04], hospitalization day [MD=-2.72, 95%CI(-3.50, -1.94), P<0.001] in trail group were better than control group, with statistical significance. The incidence of overall ADR [RR=0.39,95%CI(0.31,0.49),P<0.001], gastrointestinal ADR [RR=0.36,95%CI(0.28,0.47),P<0.001], liver toxicity [RR=0.55,95%CI(0.34,0.89),P=0.01],infusion reaction [RR=0.31,95%CI(0.20,0.48),P<0.001], rash [RR=0.34,95%CI(0.20,0.59),P<0.001], abdominal pain [RR=0.21,95%CI(0.09,0.49),P<0.001] in trail group were significantly lower than control group, with statistical significance. CONCLUSIONS: Azithromycin for injection is effective and safe in the treatment of mycoplasma pneumonia in children.
期刊: 2018年第29卷第22期
作者: 林巧楠,周鹏翔,翟所迪,赵荣生
AUTHORS: LIN Qiaonan,ZHOU Pengxiang,ZHAI Suodi,ZHAO Rongsheng
关键字: 阿奇霉素;红霉素;注射;小儿支原体肺炎;系统评价
KEYWORDS: Azithromycin; Erythromycin; Injection; Mycoplasma pneumonia of children; Systematic review
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