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皮质类固醇治疗儿童急性呼吸道疾病的安全性:一项系统评价和荟萃分析。

Safety of corticosteroids in the treatment of acute respiratory disease in children: a systematic review and meta-analysis.

作者信息

Yang Xiaoyun, Jin Hui

机构信息

Department of Pediatrics, The First Affiliated Hospital of Dalian Medical University, Dalian, China.

出版信息

Transl Pediatr. 2022 Feb;11(2):194-203. doi: 10.21037/tp-21-577.

Abstract

BACKGROUND

Oral corticosteroids are often used to treat acute asthma or asthma caused by respiratory tract infection in adult patients, but the effect of oral corticosteroids in young children is still controversial. We conducted a meta-analysis of controlled clinical studies to examine the effect of oral corticosteroids in children with respiratory diseases.

METHODS

Embase, PubMed, Web of Science, Ovid, ClinicalTrials.org from January 2000 to August 2021 were searched for randomized control trials related to the treatment of pediatric respiratory diseases with corticosteroid drugs using the keywords "corticosteroids" and "acute respiratory diseases". After screening the articles, Revman 5.4 software was used for the analysis.

RESULTS

A total of 8 articles (comprising 2,327 patients, 4 kinds of corticosteroids, and 3 types of pediatric respiratory disease) were included in the meta-analysis. The results showed that the length of hospital stay of patients in the experimental group treated with corticosteroids was shorter than that of patients in the control group [mean difference =-2.03, 95% confidence interval (CI): -2.91, -1.14; P<0.00001]. Further, the number and proportion of uncured patients after 3 days of treatment were lower in the experimental group than the control group [odds ratio (OR) =0.55, 95% CI: 0.42, 0.72; P<0.00001]. There were no differences in relation to adverse reactions (OR =0.57, 95% CI: 0.31, 1.07; P=0.08), and the readmission rate between the experimental and control groups (OR =0.94, 95% CI: 0.66, 1.34; P=0.75).

DISCUSSION

Corticosteroid use in the treatment of respiratory diseases in children can significantly shorten hospitalization time and increase the cure rate without increasing adverse reactions.

摘要

背景

口服糖皮质激素常用于治疗成年患者的急性哮喘或由呼吸道感染引起的哮喘,但口服糖皮质激素在幼儿中的疗效仍存在争议。我们进行了一项对照临床研究的荟萃分析,以检验口服糖皮质激素对患有呼吸道疾病儿童的疗效。

方法

检索2000年1月至2021年8月期间的Embase、PubMed、Web of Science、Ovid、ClinicalTrials.org,使用关键词“糖皮质激素”和“急性呼吸道疾病”搜索与使用糖皮质激素药物治疗小儿呼吸道疾病相关的随机对照试验。筛选文章后,使用Revman 5.4软件进行分析。

结果

荟萃分析共纳入8篇文章(包括2327例患者、4种糖皮质激素和3种小儿呼吸道疾病)。结果显示,接受糖皮质激素治疗的实验组患者住院时间短于对照组[平均差=-2.03,95%置信区间(CI):-2.91,-1.14;P<0.00001]。此外,治疗3天后未治愈患者的数量和比例实验组低于对照组[比值比(OR)=0.55,95%CI:0.42,0.72;P<0.00001]。不良反应方面无差异(OR =0.57,95%CI:0.31,1.07;P=0.08),实验组和对照组的再入院率也无差异(OR =0.94,95%CI:0.66,1.34;P=0.75)。

讨论

使用糖皮质激素治疗儿童呼吸道疾病可显著缩短住院时间并提高治愈率,且不增加不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3d9/8905102/7e5c8cc22a94/tp-11-02-194-f1.jpg

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