目的:探讨甲泼尼龙联合阿奇霉素治疗儿童难治性肺炎支原体肺炎的有效性及安全性。方法:检索Pubmed、Embase、Cochrane Library、Web of Science、知网、中国生物文献数据库、万方、维普数据库,检索截止日期为数据库建库至2023年10月,筛...目的:探讨甲泼尼龙联合阿奇霉素治疗儿童难治性肺炎支原体肺炎的有效性及安全性。方法:检索Pubmed、Embase、Cochrane Library、Web of Science、知网、中国生物文献数据库、万方、维普数据库,检索截止日期为数据库建库至2023年10月,筛选探讨甲泼尼龙联合阿奇霉素治疗儿童难治性肺炎支原体肺炎疗效及安全性的随机对照试验(RCT),选择符合纳排标准的文献进行Meta分析,使用RevMan 5.1软件处理数据。结果:本文最终纳入29篇文献,共计2538名患儿。Meta分析结果显示,联合使用甲泼尼龙和阿奇霉素较单用阿奇霉素能提高总有效率(RR = 1.24, 95%CI (1.19, 1.28), P MD = −2.88, 95%CI (−3.18, −2.57), P MD = −2.98, 95%CI (−3.49, −2.47), P MD = −4.15, 95%CI (−5.88, −2.42), P MD = −3.60, 95%CI (−4.58, −2.62), P MD = −15.35, 95%CI (−18.86, −11.84), P RR = 0.85, 95%CI (0.64, 1.12), P = 0.25 > 0.05)。结论:通过对现有文献的综合分析发现,甲泼尼龙联合阿奇霉素治疗儿童难治性肺炎支原体肺炎较单用阿奇霉素可以提高治疗有效性,且安全性良好。Objective: To explore the efficacy and safety of methylprednisolone combined with azithromycin in the treatment of refractory Mycoplasma pneumoniae pneumonia in children. Methods: PubMed, Embase, Cochrane Library, Web of Science, CNKI, CBM, Wanfang Database, and VIP Database were searched. The search time limit was built until October 2023. Randomized Controlled Trials (RCTs) of exploring the efficacy and safety of methylprednisolone combined with azithromycin in the treatment of children with refractory Mycoplasma pneumoniae pneumonia were included. Literature that met the criteria was selected for Meta-analysis, and RevMan 5.1 software was used to process the data. Results: 29 studies involving 2538 patients were finally included in this paper. Meta-analysis showed that the combination of methylprednisolone and azithromycin increased the overall efficacy rate compared with azithromycin alone (RR = 1.24, 95%CI (1.19, 1.28), P MD = −2.88, 95%CI (−3.18, −2.57), P MD = −2.98, 95%CI (−3.49, −2.47), P MD = −4.15, 95%CI (−5.88, −2.42), P MD = −3.60, 95%CI (−4.58, −2.62), P MD = −15.35, 95%CI (−18.86, −11.84), P = RR = 0.85, 95%CI (0.64, 1.12), P = 0.25 > 0.05). Conclusions: A comprehensive analysis of the available literature revealed that methylprednisolone combined with azithromycin for the treatment of refractory Mycoplasma pneumoniae pneumonia in children can improve the treatment effectiveness and have a good safety compared with azithromycin alone.展开更多
目的比较小剂量甲泼尼龙与尼可刹米在慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭治疗中的效果。方法选取2019年8月~2022年8月在天津市北辰医院呼吸科治疗的140例COPD合并Ⅱ型呼吸衰竭患者为研究对象,随机分为2组(n=70)。两组患者均采用无...目的比较小剂量甲泼尼龙与尼可刹米在慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭治疗中的效果。方法选取2019年8月~2022年8月在天津市北辰医院呼吸科治疗的140例COPD合并Ⅱ型呼吸衰竭患者为研究对象,随机分为2组(n=70)。两组患者均采用无创机械通气治疗,对照组加用尼可刹米375 mg与100 ml 5%的葡萄糖溶液混合,静脉滴注;观察组加用小剂量注射用甲泼尼龙40 mg与100 ml 5%的葡萄糖溶液混合,静脉滴注;两组均坚持治疗7 d。比较两组临床疗效、临床指标、肺功能、血气指标、炎症因子、健康状况。结果观察组总有效率、肺功能指标水平、PaO_(2)、pH值均高于对照组(P<0.05);观察组的临床指标优于对照组(P<0.05);治疗后观察组的炎症因子水平、PaCO_(2)水平及APACHEⅡ评分均低于对照组(P<0.05)。结论相较于尼可刹米,小剂量甲泼尼龙注射液可改善COPD合并Ⅱ型呼吸衰竭血气指标,增强肺功能,加快缓解患者的症状,减轻炎症反应,促进患者的康复。展开更多
文摘目的:探讨甲泼尼龙联合阿奇霉素治疗儿童难治性肺炎支原体肺炎的有效性及安全性。方法:检索Pubmed、Embase、Cochrane Library、Web of Science、知网、中国生物文献数据库、万方、维普数据库,检索截止日期为数据库建库至2023年10月,筛选探讨甲泼尼龙联合阿奇霉素治疗儿童难治性肺炎支原体肺炎疗效及安全性的随机对照试验(RCT),选择符合纳排标准的文献进行Meta分析,使用RevMan 5.1软件处理数据。结果:本文最终纳入29篇文献,共计2538名患儿。Meta分析结果显示,联合使用甲泼尼龙和阿奇霉素较单用阿奇霉素能提高总有效率(RR = 1.24, 95%CI (1.19, 1.28), P MD = −2.88, 95%CI (−3.18, −2.57), P MD = −2.98, 95%CI (−3.49, −2.47), P MD = −4.15, 95%CI (−5.88, −2.42), P MD = −3.60, 95%CI (−4.58, −2.62), P MD = −15.35, 95%CI (−18.86, −11.84), P RR = 0.85, 95%CI (0.64, 1.12), P = 0.25 > 0.05)。结论:通过对现有文献的综合分析发现,甲泼尼龙联合阿奇霉素治疗儿童难治性肺炎支原体肺炎较单用阿奇霉素可以提高治疗有效性,且安全性良好。Objective: To explore the efficacy and safety of methylprednisolone combined with azithromycin in the treatment of refractory Mycoplasma pneumoniae pneumonia in children. Methods: PubMed, Embase, Cochrane Library, Web of Science, CNKI, CBM, Wanfang Database, and VIP Database were searched. The search time limit was built until October 2023. Randomized Controlled Trials (RCTs) of exploring the efficacy and safety of methylprednisolone combined with azithromycin in the treatment of children with refractory Mycoplasma pneumoniae pneumonia were included. Literature that met the criteria was selected for Meta-analysis, and RevMan 5.1 software was used to process the data. Results: 29 studies involving 2538 patients were finally included in this paper. Meta-analysis showed that the combination of methylprednisolone and azithromycin increased the overall efficacy rate compared with azithromycin alone (RR = 1.24, 95%CI (1.19, 1.28), P MD = −2.88, 95%CI (−3.18, −2.57), P MD = −2.98, 95%CI (−3.49, −2.47), P MD = −4.15, 95%CI (−5.88, −2.42), P MD = −3.60, 95%CI (−4.58, −2.62), P MD = −15.35, 95%CI (−18.86, −11.84), P = RR = 0.85, 95%CI (0.64, 1.12), P = 0.25 > 0.05). Conclusions: A comprehensive analysis of the available literature revealed that methylprednisolone combined with azithromycin for the treatment of refractory Mycoplasma pneumoniae pneumonia in children can improve the treatment effectiveness and have a good safety compared with azithromycin alone.
文摘目的比较小剂量甲泼尼龙与尼可刹米在慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭治疗中的效果。方法选取2019年8月~2022年8月在天津市北辰医院呼吸科治疗的140例COPD合并Ⅱ型呼吸衰竭患者为研究对象,随机分为2组(n=70)。两组患者均采用无创机械通气治疗,对照组加用尼可刹米375 mg与100 ml 5%的葡萄糖溶液混合,静脉滴注;观察组加用小剂量注射用甲泼尼龙40 mg与100 ml 5%的葡萄糖溶液混合,静脉滴注;两组均坚持治疗7 d。比较两组临床疗效、临床指标、肺功能、血气指标、炎症因子、健康状况。结果观察组总有效率、肺功能指标水平、PaO_(2)、pH值均高于对照组(P<0.05);观察组的临床指标优于对照组(P<0.05);治疗后观察组的炎症因子水平、PaCO_(2)水平及APACHEⅡ评分均低于对照组(P<0.05)。结论相较于尼可刹米,小剂量甲泼尼龙注射液可改善COPD合并Ⅱ型呼吸衰竭血气指标,增强肺功能,加快缓解患者的症状,减轻炎症反应,促进患者的康复。