人免疫球蛋白辅助治疗小儿重症肺炎有效性及安全性的Meta分析

摘要

目的 评价人免疫球蛋白辅助治疗小儿重症肺炎的有效性及安全性,为临床提供循证依据.方法 计算机检索PubMed、中国知网(CNKI)、维普网(VIP)、万方数据知识服务平台等数据库,并手工检索相关参考文献,筛选检索有关人免疫球蛋白治疗小儿重症肺炎的随机对照研究(RCT),检索时间为从建库至2016年8月.对照组患儿给予常规治疗,试验组患儿在常规治疗基础上给予人免疫球蛋白.采用RevMan 5.2软件进行Meta分析.结果 最终纳入14篇文献,包括1 353例患儿,其中对照组670例、试验组683例.Meta分析结果显示,试验组患儿总有效率高于对照组[相对危险度(RR)=1.12,95％CI (1.07,1.16),P＜0.000 01],住院时间[均数差(MD)=-1.55,95％CI(-2.03,-1.07),P＜0.000 01]、体温恢复正常时间[MD=-1.25,95％ CI(-1.64,-0.86),P＜0.000 01]、咳嗽消失时间[MD=-1.50,95％ CI(-1.84,-1.17),P＜0.000 01]和肺部啰音消失时间[MD=-1.50,95％CI (-1.91,-1.09),P＜0.000 01]短于对照组.两组患儿药品不良反应(ADR)发生率比较,差异无统计学意义[RR =0.57,95％CI (0.26,0.95),P=0.16].结论 现有文献证据表明,人免疫球蛋白辅助治疗小儿重症肺炎的临床疗效确切,能有效缩短患儿住院时间、体温恢复正常时间及咳嗽和肺部啰音消失时间,且安全性较高.%Objective To evaluate the effectiveness and safety of human immune globulin in the adjuvant therapy for severe pneumonia in children.Methods RCTs about effectiveness and safety of human immune globulin in the adjuvant therapy for severe pneumonia in children were searched in PubMed,CNKI,VIP and Wanfang Data by computer from creating database to August 2016,and relevant references were manually searched,thereinto children of control group received conventional treatment,while children of test group received human immune globulin based on conventional treatment.RevMan 5.2 software was used to conduct the Meta-analysis.Results A total of 14 literatures were involved,including 1,353 cases (670 cases in control group and 683 cases in test group).Meta-analysis results showed that,the total effective rate of test group was statistically significantly higher than that of control group [RR =1.12,95％CI (1.07,1.16),P ＜0.000 01],hospital stays [MD=-1.55,95％ CI (-2.03,-1.07),P ＜ 0.000 01],recovery time of temperature [MD =-1.25,95％ CI (-1.64,-0.86),P＜0.00001],disappearance time of cough [MD=-1.50,95％CI (-1.84,-1.17),P＜0.000 01] and disappearance time of lung rale [MD=-1.50,95％CI (-1.91,-1.09),P＜0.000 01] of test group were statistically significantly shorter than those of control group,while no statistically significant differences of incidence of adverse drug rcaetions was found between the two groups [RR =0.57,95％ CI (0.26,0.95),P =0.16].Conclusion According to existing literatures,human immune globulin has certain clinical effect in the adjuvant therapy for severe pneumonia in children,can effectively shorten the hospital stays,recovery time of temperature,disappearance time of cough and lung rale,with relatively high safety.