吸入糖皮质激素治疗婴幼儿毛细支气管炎的meta分析

Efficacy of inhaled corticosteroids for bronchiolitis in infants:a meta-analysis

目的系统评价吸入糖皮质激素(ICS)治疗婴幼儿毛细支气管炎的疗效及安全性。方法系统检索PubMed、Embase、Cochrane library、中国知网、万方数据库、中国生物医学文献数据库中发表的关于ICS治疗婴幼儿毛细支气管炎的随机对照试验(RCTs),采用RevMan5.3软件及Stata12.0软件对数据进行meta分析。结果共纳入9项研究,1047例患儿。meta分析结果显示:ICS可明显缩短喘憋缓解时间(MD=-1.25d,95%CI:-1.47~-1.04,P<0.01)及肺部哮鸣音消失时间(MD=-1.96d,95%CI:-2.97~-0.95,P=0.0001),但不能缩短平均住院时间(MD=-0.87d,95%CI:-2.00~-0.25,P=0.13)及降低毛细支气管炎再发喘息发生率(OR=0.85,95%CI:0.40~1.79,P=0.67)。纳入研究均未见严重不良事件报道。结论ICS可改善毛细支气管炎患儿急性期症状及体征,但不能预防毛细支气管炎后喘息的发生。

Objective To systematically evaluate the efficacy of inhaled corticosteroids(ICS)in infants with bronchiolitis.Methods Related databases such as PubMed,Embase,Cochrane library,CNKI,Wangfang database,were comprehensively searched for relevant randomized controlled trials about ICS intreatment of bronchiolitis in infants.RevMan 5.3 software and Stata 12.0 software were used for performing this meta-analysis.Results A total of 9 studies,involved 1047 patients were included in this meta-analysis.Meta-analysis showed that,ICS could significantly shorten asthmatic relief time(MD=-1.25 d,95%CI:-1.47--1.04,P<0.01)and the time of wheezing rale disappearance(MD=-1.96 d,95%CI:-2.97--0.95,P=0.0001),while ICS showed no effect on reducing average hospitalization time(MD=-0.87 d,95%CI:-2.00--0.25,P=0.13)and incidence of post-bronchiolitic wheezing(OR=0.85,95%CI:0.40-1.79,P=0.67).No serious adverse events were observed in all included studies.Conclusion ICS can improve clinical symptoms and signs in infants with bronchiolitis,while it has effect on preventing post-bronchiolitic wheezing.