Lu Jinmiao, Zhang Junqi, Wang Guangfei, Zhang Xiaobo, Li Zhiping
Department of Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China.
Department of Respiratory Disease, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China.
Front Pediatr. 2023 Jan 4;10:1066640. doi: 10.3389/fped.2022.1066640. eCollection 2022.
The purpose of this study was to evaluate the efficacy and safety of BAL in treating MPP.
From January 2013 to January 2019, 1,689 pediatric patients with MPP were analyzed retrospectively. Patients were subdivided into BAL group and non-BAL group according to whether they received BAL treatment within seven days after admission. The propensity score matching method matched patients' baseline characteristics (1:1). The primary outcomes were hospital stays and the cure rate. Secondary outcomes included mortality, co-infection, repeat hospitalization within 30 days, and total cost of treatment.
After matching, 524 patients (BAL: 262; control: 262) were recorded. The BAL group had significantly shorter hospital stays (OR: 0.5, 95% CI: 0.4-0.7). Meanwhile, BAL did not significantly modify the cost, co-infection rate, and mortality. In subgroup analyses, the group with BAL intervention within three days had a significantly shorter hospital stay (OR: 0.4, 95% CI: 0.3-0.5) compared with the group with BAL intervention three days after admission.
Early BAL intervention is a better treatment than conventional drug therapy alone, and no significant complications were seen in this study. BAL intervention has an excellent clinical benefit. The earlier the intervention, the better the effect.
本研究旨在评估支气管肺泡灌洗(BAL)治疗支原体肺炎(MPP)的疗效和安全性。
回顾性分析2013年1月至2019年1月期间1689例儿童MPP患者。根据患者入院后7天内是否接受BAL治疗,将其分为BAL组和非BAL组。采用倾向评分匹配法对患者的基线特征进行1:1匹配。主要结局指标为住院时间和治愈率。次要结局指标包括死亡率、合并感染、30天内再次住院率及治疗总费用。
匹配后,记录了524例患者(BAL组:262例;对照组:262例)。BAL组的住院时间显著缩短(比值比:0.5,95%置信区间:0.4 - 0.7)。同时,BAL对费用、合并感染率及死亡率无显著影响。在亚组分析中,入院后3天内接受BAL干预的组与入院3天后接受BAL干预的组相比,住院时间显著缩短(比值比:0.4,95%置信区间:0.3 - 0.5)。
早期BAL干预比单纯传统药物治疗效果更好,且本研究中未观察到明显并发症。BAL干预具有良好的临床效益。干预越早,效果越好。