硫酸镁治疗儿童哮喘急性发作的系统评价

Systematic review on magnesium sulphate for the treatment of acute asthma in children

目的:评价静脉注射和雾化吸入硫酸镁治疗儿童哮喘急性发作的有效性。方法:系统检索Cochrane图书馆、Medline、PubMed、Embase、CNKI、VIP、CBM数据库,全面收集静脉注射和雾化吸入硫酸镁对比安慰剂治疗儿童哮喘急性发作的随机对照试验(RCT),对符合纳入标准的文献进行质量评价,并运用Rev Man 5.2软件进行Meta分析。结果:共纳入9个RCT,844例患者。Meta分析结果显示,与对照组比较,静脉注射硫酸镁可以降低患儿的住院率,改善患儿的肺功能(P<0.05),未降低患儿的哮喘症状评分;与对照组比较,雾化吸入硫酸镁可以改善患儿的肺功能(P<0.05),未降低患儿的住院率及哮喘症状评分。结论:静脉注射和雾化吸入硫酸镁可以改善儿童哮喘急性发作临床疗效中的某些指标,但其疗效及安全性尚需更多高质量、大样本、多中心的RCT加以验证。

Objective： To estimate the effect of intravenous and nebulised magnesium sulphate on children with acute asthma. Methods： Published randomized controlled trials （RCTs） focused on intravenous and nebulised magnesium sulphate vs placebo in the treatment of children with acute asthma in Cochrane Library, Medline, PubMed, Embase, CNKI, VIP, CBM database were collected. The methodological quality of the included studies was evaluated and the forest plot with meta-analysis was drawn by RevMan 5.2. Results：A total of 9 RCTs were included, involving 844 patients. The results of meta-analysis revealed that compared with control group, intravenous magnesium sulphate could decrease the hospitalization rate and improve pulmonary function in children （P〈0.05）, but couldn＆#39;t reduce the clinical symptom scores. Compared with control group, nebulised magnesium sulphate could improve pulmonary function in children （P〈0.05）, but couldn＆#39;t decrease the hospitalization rate and clinical symptom scores. Conclusion： Intravenous and nebulised magnesium sulphate could improve some clinical indicators of acute asthma in children. However, high quality, large samples and multiple center RCTs are still required to conifrm the efifcacy and safety.