摘要
目的：探讨吸入糖皮质激素治疗儿童哮喘的有效性及安全性。方法：按照系统评价的要求全面检索PubMei、中国期刊镜像网、万方数字化期刊等相关网站，采用RevMan4．2软件，对符合纳入标准的19篇文献共计1994名儿童进行了Meta-分析。结果：总有效率来源文献具有同质性，吸入糖皮质激素组与对照组比较合并结果具有统计学意义[OR=8．27，95％CI（5．20～13．16）]。治疗6个月血清骨钙素含量、治疗12个月血清骨钙素含量和身高增长速率来源文献有异质性，血ACTH水平来源文献具有同质性。吸入糖皮质激素组与对照组比较，身高增长速率的合并效应量差异有统计学意义；其他3项指标的差异无统计学意义。通过敏感性分析显示，治疗总有效率、身高增长速率和血ACTH水平的分析结果比较稳定、可靠；治疗6个月血清骨钙素含量和12个月血清骨钙素含量的比较结果仍需要进一步探讨。发表偏倚分析结果显示发表偏倚的影响不大，结论比较可靠。结论：现有证据表明，吸入糖皮质激素治疗儿童哮喘的有效性及安全性较高，但仍需通过加大样本量及严密的设计，来进一步分析，以期得到更为稳定、可靠的结果。
Objective To assess the efficacy and safety of inhaled corticosteoids for childhood asthma. Methods According to the requirements of Cochrane systematic review, a thorough literature search was performed among PubMed, China National Knowledge Infrastructure, Wanfang Date, and so on. With RevMan 4.2 software, a Meta-analysis was performed on a total of 1 994 children involved in 19 papers which met with the inclusion criteria. Results The literatures of total effective rates had homogenicity. In comparison of the treatment groups and the control, the incorporation was statistically significant [OR=8.27, 95%CI （5.20, 13. 16）1. The literatures of serum osteocalcin levels after the treament for 6 and 12 months and growth rates had heterogeneity, and that of serum ACTH levels had homogenicity. Comparing the treatment group with the control group, the incorporation of the growth rates had statistical difference, while the other three incorporations did not. Sensitivity analysis showed that the results of total effective rates, serum osteocalcin levels after the treament for 12 months,growth rates and serum ACTH levels were stable and reliable, but that of serum osteocalcin levels after 6 months treament required further approach. The results of publication bias showed that the impact was small, and the results was reliable. Conclusion The clinical evidences available so far indicats that the treatment of childhood asthma with inhaled corticosteroids is safe and elective, although rigorous designe and large sample size randomized double-blind clinical trials are required to further analysis for more stable and reliable results.
出处
《吉林大学学报（医学版）》
CAS
CSCD
北大核心
2006年第5期883-887,共5页
Journal of Jilin University：Medicine Edition
基金
国家自然科学基金资助课题(30370669)
