CAJ | 학술논문

目的评价硫酸镁雾化吸入在儿童哮喘急性发作治疗中的疗效.方法通过对中国期刊数据库(CNKI)、中国科技期刊数据库(VIP)、万方数据库进行系统检索,以“硫酸镁”“沙丁胺醇”和“哮喘”作为检索词,收集发表的所有硫酸镁雾化治疗儿童哮喘急性发作研究的文献.对已发表的比较单独硫酸镁溶液雾化和以硫酸镁溶液为溶媒吸入沙丁胺醇对儿童哮喘急性发作疗效的临床随机对照试验结果进行Meta分析.结果对入选4项研究857例哮喘急性发作患者的Meta分析表明,以硫酸镁溶液为溶媒吸入沙丁胺醇与单独硫酸镁溶液相比较,患者的肺功能指标有一定的改善[合并标准化均数差为0.31[95％置信区间(C1):0.06 ～0.57,P＜0.05].未发现以硫酸镁溶液作溶媒雾化吸入沙丁胺醇可降低对儿童哮喘发作患者的不良反应发生[合并相对危险度(RR)为0.97[95％ CI:0.68 ～ 1.40,P＞0.05],发表偏倚分析发现,各研究间存在明显的发表偏倚(Z =2.47,P ＜0.001).结论与单独雾化吸入硫酸镁比较,以硫酸镁溶液作为溶媒雾化吸入沙丁胺醇是一种改善儿童哮喘发作患者肺功能的更为有效治疗方法.该疗法使用的安全性有待进一步研究评估.
목적 평개류산미무화흡입재인동효천급성발작치료중적료효.방법 통과대중국기간수거고(CNKI)、중국과기기간수거고(VIP)、만방수거고진행계통검색,이“류산미”“사정알순”화“효천”작위검색사,수집발표적소유류산미무화치료인동효천급성발작연구적문헌.대이발표적비교단독류산미용액무화화이류산미용액위용매흡입사정알순대인동효천급성발작료효적림상수궤대조시험결과진행Meta분석.결과 대입선4항연구857례효천급성발작환자적Meta분석표명,이류산미용액위용매흡입사정알순여단독류산미용액상비교,환자적폐공능지표유일정적개선[합병표준화균수차위0.31[95％치신구간(C1):0.06 ～0.57,P＜0.05].미발현이류산미용액작용매무화흡입사정알순가강저대인동효천발작환자적불량반응발생[합병상대위험도(RR)위0.97[95％ CI:0.68 ～ 1.40,P＞0.05],발표편의분석발현,각연구간존재명현적발표편의(Z =2.47,P ＜0.001).결론 여단독무화흡입류산미비교,이류산미용액작위용매무화흡입사정알순시일충개선인동효천발작환자폐공능적경위유효치료방법.해요법사용적안전성유대진일보연구평고.
Objective To assess the efficacy of magnesium sulfate for aerosol inhalation in treatment of children asthma exacerbations.Methods All relevant randomized eontrolled clinical trials (RCT) with isotonic magnesium sulphate and saline for inhaled salbutamol in treatment of children asthma exacerbations were searched with the key words of asthma,salbutamol and magnesium sulfate.A Meta-analysis was performed to evaluate the result of the magnesium sulfate.Results Four relevant RCTs from literatures were collected and totally 857 cases were included for analysis.The Meta-analysis indicated that the improvements were obtained from isotonic magnesium sulfate as a vehicle for nebulized salbutamol,in comparison with only magnesium sulfate[pooled standardized mean difference(SMD) =0.31,95％ confidence interval:0.06-0.57,P ＜ 0.05].The occurrence of adverse reactions of children asthma exacerbation were not statistically reduced among inpatients using magnesium sulfate as a vehicle for nebulized salbutamol and only using magnesium sulfate[pooled relative risk =0.97,95％ CI:0.68-1.40,P ＞ 0.05].Analysis of publication bias between the various research found that among the obvious publication bias (Z =2.47,P ＜ 0.001).Conclusions Compared with only magnesium sulfate,the use of isotonic magnesium sulfate as an adjuvant to nebulize salbutamol is a good therapy with improving pulmonary function in the children asthma exacerbation.The safety of the therapy needs further research assessment.