Wang Linlin, Song Yuanlin
Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Shanghai Public Health Clinical Center, Shanghai, 201508, China.
Clin Respir J. 2018 Mar;12(3):857-864. doi: 10.1111/crj.12646. Epub 2017 May 31.
Pneumonia is a major cause of morbidity and mortality of children. Zinc is known to play a central role in the immune system. The deficiency of zinc increased susceptibility to infectious diseases.
To investigate the clinical efficacy of zinc given as an adjunct therapy to the treatment of severe pneumonia.
The PubMed, Embase, MEDLINE and the Cochrane Central Register of Controlled Trials were searched to identify all randomized, double-blind and placebo-controlled (DBPC) trials which evaluated the clinical efficacy of zinc given as an adjunct in the treatment of severe pneumonia and published between January 1966 and October 2015.
Six randomized DBPC trials including 2216 patients with severe pneumonia were eligible. The results suggested that zinc given as an adjunct therapy to the treatment of severe pneumonia had no significant improvement of treatment failure (RR = 0.97, P = .71) and change of antibiotic therapy (RR = 1.09, P = .52). We also found a favorable trend for clinical deterioration of severe pneumonia but with no statistical significance (RR = 0.88, P = .55). Zinc produced a significant reduction in mortality caused by severe pneumonia (RR = 0.43, P = .01).
Zinc given as an adjunct to the treatment of severe pneumonia is effective in reducing the mortality of severe pneumonia, and has no significant effects on treatment failure and change of antibiotic therapy.
肺炎是儿童发病和死亡的主要原因。锌在免疫系统中起着核心作用。锌缺乏会增加对传染病的易感性。
探讨锌作为辅助治疗手段用于重症肺炎治疗的临床疗效。
检索PubMed、Embase、MEDLINE以及Cochrane对照试验中心注册库,以识别所有在1966年1月至2015年10月期间发表的评估锌作为辅助治疗手段用于重症肺炎治疗的临床疗效的随机、双盲和安慰剂对照试验。
六项随机双盲安慰剂对照试验符合要求,共纳入2216例重症肺炎患者。结果表明,锌作为辅助治疗手段用于重症肺炎治疗,在治疗失败率(RR = 0.97,P = 0.71)和抗生素治疗变化方面(RR = 1.09,P = 0.52)无显著改善。我们还发现重症肺炎临床恶化存在有利趋势,但无统计学意义(RR = 0.88,P = 0.55)。锌可显著降低重症肺炎导致的死亡率(RR = 0.43,P = 0.01)。
锌作为辅助治疗手段用于重症肺炎治疗可有效降低重症肺炎的死亡率,且对治疗失败率和抗生素治疗变化无显著影响。