阿奇霉素联合静脉用丙种球蛋白治疗儿童难治性肺炎支原体肺炎的疗效：Meta 分析。

Efficacy of azithromycin combined with intravenous immunoglobulin in the treatment of refractory mycoplasma pneumoniae pneumonia in children: a meta-analysis.

机构信息

Clinical Skills Teaching and Training Center, Hubei University of Medicine, Shiyan, Hubei, 442000, China.

Department of Surgery, Shiyan Maternal and Child Health Hospital, Shiyan, Hubei, 442000, China.

出版信息

BMC Pediatr. 2024 Oct 25;24(1):678. doi: 10.1186/s12887-024-05150-x.

DOI:10.1186/s12887-024-05150-x

PMID:39455988

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11515308/

Abstract

BACKGROUND

The incidence of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children is increasing, posing a serious threat to life safety. Intravenous immunoglobulin (IVIG) has demonstrated the ability to modulate the immune system and has shown the potential to treat RMPP. This study evaluated the clinical efficacy and safety of azithromycin combined with IVIG in the treatment of RMPP in children through a meta-analysis.

METHODS

A comprehensive search was conducted in seven databases including PubMed and Cochrane Library, and the studies on the treatment of RMPP in children with azithromycin combined with IVIG were screened. After data extraction, meta-analysis and sensitivity analysis were performed to assess heterogeneity and stability.

RESULTS

Thirteen randomized controlled trials and two cohort studies were included, totaling 1,142 children. The results of meta-analysis showed a higher clinical efficacy rate (RR = 1.18, 95% CI: 1.11-1.25, P < 0.01) and shorter time to defervescence (MD = -2.12, 95% CI: -2.69--1.55), time to disappearance of pulmonary rales (MD = -2.90, 95% CI: -3.57--2.23), time to disappearance of cough (MD = -3.59, 95% CI: -4.51--2.67), and hospital length of stay (MD = -5.72, 95% CI: -8.80--2.64) in the experimental group receiving azithromycin combined with IVIG treatment compared to the control group treated with azithromycin alone. Additionally, there was no significant publication bias in this meta-analysis.

CONCLUSION

Treatment with azithromycin combined with IVIG is more effective than treatment with azithromycin alone for children with RMPP.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

儿童难治性肺炎支原体肺炎（RMPP）的发病率不断上升，对生命安全构成严重威胁。静脉注射免疫球蛋白（IVIG）具有调节免疫系统的能力，并显示出治疗 RMPP 的潜力。本研究通过荟萃分析评估了阿奇霉素联合 IVIG 治疗儿童 RMPP 的临床疗效和安全性。

方法

在 PubMed 和 Cochrane Library 等七个数据库中进行全面检索，筛选出阿奇霉素联合 IVIG 治疗儿童 RMPP 的研究。提取数据后，进行荟萃分析和敏感性分析，以评估异质性和稳定性。

结果

纳入 13 项随机对照试验和 2 项队列研究，共 1142 例儿童。荟萃分析结果显示，实验组（阿奇霉素联合 IVIG 治疗）的临床疗效更高（RR=1.18，95%CI：1.11-1.25，P<0.01），退热时间（MD=-2.12，95%CI：-2.69--1.55）、肺部啰音消失时间（MD=-2.90，95%CI：-3.57--2.23）、咳嗽消失时间（MD=-3.59，95%CI：-4.51--2.67）和住院时间（MD=-5.72，95%CI：-8.80--2.64）更短。此外，本荟萃分析无明显发表偏倚。