中国大陆地区甲泼尼龙联合阿奇霉素治疗小儿难治性支原体肺炎的Meta分析

Methylprednisolone combined with azithromycin in the treatment of pediatric refractory mycoplasma pneumonia in China's Mainland:a Meta-analysis

目的定量评价甲泼尼龙联合阿奇霉素治疗小儿难治性支原体肺炎的疗效。方法检索中国知网、万方医学网、维普期刊资源网、中国科学引文数据库和中国生物医学文献数据库,以及PubMed,EMBASE数据库,对检索到的有关甲泼尼龙联合阿奇霉素对比单用阿奇霉素治疗小儿难治性支原体肺炎文献进行筛选,评估和提取数据,应用Stata12.0软件进行Meta分析。结果最终纳入16篇文献,共有1484名病例。观察组用药为甲泼尼龙联合阿奇霉素,对照组用药为阿奇霉素,两组治疗小儿难治性支原体肺炎疗效的合并OR (95%CI)值为6.51(4.25～9.96),差异有统计学意义(P <0.001);两组治疗小儿难治性支原体肺炎降低面部潮红的合并OR (95%CI)值为0.39(0.12～1.27),差异无统计学意义(P=0.120),两组降低消化道反应的合并OR (95%CI)值为1.02(0.46～2.25),差异无统计学意义(P=0.968)。结论甲泼尼龙联合阿奇霉素治疗小儿难治性支原体肺炎可显著提高疗效,无明显降低不良反应作用。

Objective To quantitativly evaluate the efficacy of methylprednisolone combined with azithromycin in the treatment of pediatric refractory mycoplasma pneumonia in China's Mainland.Methods Publications on methylprednisolone combined with azithromycin versus azithromycin alone for treating pediatric refractory mycoplasma pneumonia were retrieved from China National Knowledge Index (CNKI),Wanfang,Chongqing VIP network,Chinese Science Citation Database (CSCD),China Biomedical Medicine (CBM),PubMed and EMBASE.The Stata software (version 12.0) was used for Meta-analysis of the data from the literatures.Results Sixteen articles (including 1484 cases) were finally included into the analysis.The observation group used methylprednisolone combined with azithromycin and the control group used azithromycin alone.Meta-analysis indicated that methylprednisolone combined with azithromycin could treat pediatric refractory mycoplasma pneumonia better than azithromycin alone (pooled OR =6.51,95% CI :4.25~9.96),there was statistically significant difference (P<0.001).While treating for pediatric refractory mycoplasma pneumonia,the two groups had no statistical differences in reducing facial flushing (pooled OR =0.39,95% CI :0.12 ~1.27,P=0.120) and gastrointestinal reaction (pooled OR =1.02,95% CI :0.46~2.25,P=0.968).Conclusion Methylprednisolone combined with azithromycin can obviously improve the therapeutic efficacy of treating pediatric refractory mycoplasma pneumonia and have no obvious function in reducing adverse reaction.