阿奇霉素序贯疗法与常规治疗社区获得性肺炎的荟萃分析

摘要

Objective To compare the efficacy and safety of azithromycin consecutive and conventional therapy for the treatment for community-acquired pneumonia (CAP). Methods The randomized controlled trials regarding azithromycin consecutive (research group) and conventional intravenous therapy (control group) on CAP were searched from WANFANG data and CNKI. And the efficacy, adverse reaction and duration of intravenous drip were evaluated by meta-analysis. Results Seven RCTs were included in this study. There was no significant difference in the total effective rate (Z=1.03, P=0.30, OR=1.36, 95% CI 0.76-2.43), whereas the differences in the incidence of adverse events (Z=5.19, P<0.01, OR=0.37, 95% CI 0.26-0.54) and the duration of intravenous drip (Z=36.84, P<0.01, WMD=-6.52, 95%CI-6.87~-6.18) were statistically significant. There was nil publication bias as analyzed by Begg′s test and Egger′s test. Conclusion Azithromycin consecutive therapy for CAP is safe and effective.%目的：比较阿奇霉素序贯疗法与常规治疗社区获得性肺炎（CAP）的疗效和安全性。方法检索万方数据库“WANFANGDATA”和中国知网数据库（CNKI），查找关于阿奇霉素序贯治疗（研究组）和常规静脉滴注治疗（对照组）CAP的随机对照研究。采用Meta分析方法分析阿奇霉素序贯疗法与常规治疗CAP的临床疗效、不良反应和静脉滴注时间。结果共纳入7项研究。结果显示研究组和对照组的临床总有效率差异无统计学意义（Z＝1．03，P＝0．30，OR＝1．36，95％CI 0．76~2．43）；2组不良反应发生率（Z＝5．19，P＜0．01，OR＝0．37，95％CI 0．26~0．54）和静脉滴注时间（Z＝36．84，P＜0．01，WMD＝-6．52，95％CI-6．87~-6．18）比较差异有统计学意义。Begg′s检验和Egger′s检验显示无发表性偏倚。结论阿奇霉素序贯疗法治疗CAP安全有效。