Health Protection and Influenza Research Group, Division of Epidemiology and Public Health, University of Nottingham, United Kingdom.
J Infect Dis. 2013 Feb 15;207(4):553-63. doi: 10.1093/infdis/jis726. Epub 2012 Nov 29.
The impact of neuraminidase inhibitor (NAI) treatment on clinical outcomes of public health importance during the 2009-2010 pandemic has not been firmly established.
We conducted a systematic review and meta-analysis, searching 11 databases (2009 through April 2012) for relevant studies. We used standard methods conforming to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using random effects models.
Regarding mortality we observed a nonsignificant reduction associated with NAI treatment (at any time) versus none (OR, 0.72 [95% CI, .51-1.01]). However we observed significant reductions for early treatment (≤48 hours after symptom onset) versus late (OR, 0.38 [95% CI, .27-.53]) and for early treatment versus none (OR, 0.35 [95% CI, .18-.71]). NAI treatment (at any time) versus none was associated with an elevated risk of severe outcome (OR, 1.76 [95% CI, 1.22-2.54]), but early versus late treatment reduced the likelihood (OR, 0.41 [95% CI, .30-.56]).
During the 2009-2010 influenza A(H1N1) pandemic, early initiation of NAI treatment reduced the likelihood of severe outcomes compared with late or no treatment.
CRD42011001273.
神经氨酸酶抑制剂（NAI）治疗对 2009-2010 年大流行期间具有公共卫生重要性的临床结局的影响尚未得到明确证实。
我们进行了系统评价和荟萃分析，在 11 个数据库（2009 年至 2012 年 4 月）中搜索相关研究。我们使用符合系统评价和荟萃分析报告的首选项目（PRISMA）指南的标准方法。使用随机效应模型估计合并的优势比（OR）和 95％置信区间（CI）。
关于死亡率，我们观察到与 NAI 治疗（任何时间）与无治疗（OR，0.72 [95％CI，0.51-1.01]）相关的无显著性降低。然而，我们观察到早期治疗（发病后 48 小时内）与晚期治疗（OR，0.38 [95％CI，0.27-0.53]）和早期治疗与无治疗（OR，0.35 [95％CI，0.18-0.71]）之间的显著降低。任何时间的 NAI 治疗与无治疗与严重结局的风险升高相关（OR，1.76 [95％CI，1.22-2.54]），但早期治疗与晚期治疗降低了这种可能性（OR，0.41 [95％CI，0.30-0.56]）。
在 2009-2010 年甲型 H1N1 流感大流行期间，与晚期或无治疗相比，早期开始 NAI 治疗可降低严重结局的可能性。
CRD42011001273。
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