干扰素治疗儿童病毒性心肌炎疗效的Meta分析

Meta-analysis on curative effect of interferon on children with viral myocarditis

目的：评价干扰素治疗儿童病毒性心肌炎的临床疗效。方法计算机检索PubMed、MEDLINE、Cochrane Controlled Trials Register、中国学术期刊网络出版总库CNKI （1979-2015）、万方医学数据库（1998-2015）、维普中文科技期刊全文数据库（1989-2015）中关于常规疗法联合干扰素（试验组）对比常规组（对照组）治疗小儿病毒性心肌炎的随机对照试验，对符合标准的随机对照试验进行Meta分析。结果共有9篇符合条件文献入选，所有文献质量均较低。 Meta分析结果显示，试验组疗效优于对照组，总效应Z＝5.96（P〈0.001），OR 4.07（95％CI 2.56-6.45），两组差异有统计学意义；治疗结束时心肌酶谱及心律失常的好转率差异有统计学意义，分别为 Z ＝5.59（ P 〈0.001）， OR 4.66（95％CI 2.72-8.00）和Z＝5.00（P〈0.001），OR 4.62（95％CI 2.54-8.42）；漏斗图分析结果显示发表偏倚的可能性较小。结论病毒性心肌炎小儿患者在常规治疗基础上联合应用干扰素可有效改善患儿临床疗效及症状；尚需更多高质量研究进一步验证。

Objective To review the curative effect of interferon on children with viral myocarditis. Methods The databases of PubMed,MEDLINE,Cochrane Controlled Trials Register,CNKI（1979-2015）, Wanfang Database（1998-2015）and VIP Database（1989-2015）were retrieved for collecting the randomized controlled trials（ RCTs） on the comparison of treating children viral myocarditis with routine Western medical therapy combining interferon（ experimental group） and routine Western medical therapy（ control group） . The eligible RCTs were given Meta-analysis. Results There were totally 9 eligible RCTs and the quality of all RCTs reached grade C. The results of Meta-analysis showed that the curative effect was better in experimental group than that in control group and the total effective rate was Z=5. 96 （ P 〈0. 001 ） , OR 4. 07 （ 95%CI 2. 56-6. 45）. When the treatment ended,the changes of myocardial enzymes and arrhythmia had statistical difference[respectively：Z=5. 59（P〈0. 001）,OR 4. 66（95%CI 2. 72-8. 00）and Z=5. 00（P〈0. 001）,OR 4. 62（95%CI 2. 54-8. 42）]. The analysis results of funnel plots showed that there was barely bias in the Meta-analysis on curative effect. Conclusion Routine Western medical therapy combining interferon can significantly improve curative effect and relieve the symptoms in the children with children viral myocarditis.