糖皮质激素治疗传染性单核细胞增多症的系统评价

Review of Glucocorticoid Therapy for Infectious Mononucleosis

目的:评价糖皮质激素对症治疗传染性单核细胞增多症的有效性和安全性。方法:检索Cochrane图书馆、MEDLINE、EMBASE、FMJS、CNKI等数据库(1974年1月～2012年2月)中有关糖皮质激素与其他药物对症治疗传染性单核细胞增多症疗效比较的随机对照试验,并用Revman 4.2软件进行Meta分析。结果:共纳入文献6篇:2个研究显示激素治疗12 h咽痛可有缓解,但维持时间较短;1个研究显示激素联用抗病毒药疗效维持较长;1个研究表明激素联用抗病毒药治疗20 d后可明显改善疲劳症状,但由于药物联用使得疗效价值并不确切;2个研究报道激素组出现严重不良反应及并发症。结论:没有足够证据支持使用糖皮质激素对症治疗传染性单核细胞增多症。

Objective： To determine the efficacy and safety of glucocorticoid therapy for infectious mononucleosis. Methods： We searched the Cochrane Library, MEDLINE, EMBASE, FMJS, and CNKI databases（ 1974.1 -2012.2 ）for randomized controlled trials involving the efficacy and safety of glucocorticoid therapy for infectious mononucleosis. Revman 4.2 software was used for Meta-analysis. Results： Six trials were included. Compared with the control group, two studies suggested a benefit of glucocorticoid therapy for sore throat at 12 hours, but the benefit was not maintained. One trial suggested a longer benefit when the steroid was combined with an antiviral drug. One trim showed that glucocorticoid may improve resolution of fatigue at 20 days. However, it was unclear if this was only in combination with an antiviral. Two trials reported severe adverse events or complications in glucocorticoid group participants. Conclusions： There is insufficient evidence to recommend steroid treatment for infectious mononucleosis.