中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2015年
22期
1716-1720
,共5页
赵劭懂%陈俊%葛许华%刘勇%时珺%张琴%喻文亮
趙劭懂%陳俊%葛許華%劉勇%時珺%張琴%喻文亮
조소동%진준%갈허화%류용%시군%장금%유문량
手足口病%静脉用丙种球蛋白%随机对照试验%系统评价%Meta分析
手足口病%靜脈用丙種毬蛋白%隨機對照試驗%繫統評價%Meta分析
수족구병%정맥용병충구단백%수궤대조시험%계통평개%Meta분석
Hand-foot-mouth disease%Intravenous immunoglobulin%Randomized controlled trial%Systematic review%Meta analysis
目的 评价静脉用丙种球蛋白(IVIG)治疗危重症手足口病的有效性.方法 检索PubMed、MEDLINE、EMBASE、EBSChost、Cochrane图书馆、Cochrane临床对照试验库(CENTRAL)、Ovid、中国生物医学文献数据库、万方数据库、中国知网、维普中文科技期刊数据库及所获的参考文献、灰色文献,筛选所有应用IVIG治疗危重症手足口病的临床试验.选择文献、评价质量、提取资料并交叉核对,采用Rev Man 5.3软件进行Meta分析.结果 纳入11篇文献,共967例.分析结果显示:与常规治疗组相比,IVIG组患儿在总体疗效(OR=6.84,95％CI:3.74 ～ 12.52,P＜0.05)、热程[均数差(MD)=-1.94,95％CI:-3.07 ～-0.81,P＜0.05]、留院时间(MD=-4.56,95％CI:-8.95～-0.17,P＜0.05)等方面比较,差异均有统计学意义.不同剂量IVIG时,患儿热程(MD=-0.28,95％CI:-0.59～0.03,P＞0.05)、皮疹消退(MD =0.18,95％ CI:-0.22～0.59,P＞0.05)、留院时间(MD=-0.12,95％CI:-0.47～0.23,P＞0.05)比较,差异均无统计学意义.结论 在危重症手足口病患儿的治疗中,IVIG能有效缩短发热时间、减少留院时间,值得推荐.开展严格的试验设计,多中心、大样本的临床试验有助于进一步明确IVIG在危重症手足口病治疗中的有效性和安全性.
目的 評價靜脈用丙種毬蛋白(IVIG)治療危重癥手足口病的有效性.方法 檢索PubMed、MEDLINE、EMBASE、EBSChost、Cochrane圖書館、Cochrane臨床對照試驗庫(CENTRAL)、Ovid、中國生物醫學文獻數據庫、萬方數據庫、中國知網、維普中文科技期刊數據庫及所穫的參攷文獻、灰色文獻,篩選所有應用IVIG治療危重癥手足口病的臨床試驗.選擇文獻、評價質量、提取資料併交扠覈對,採用Rev Man 5.3軟件進行Meta分析.結果 納入11篇文獻,共967例.分析結果顯示:與常規治療組相比,IVIG組患兒在總體療效(OR=6.84,95％CI:3.74 ～ 12.52,P＜0.05)、熱程[均數差(MD)=-1.94,95％CI:-3.07 ～-0.81,P＜0.05]、留院時間(MD=-4.56,95％CI:-8.95～-0.17,P＜0.05)等方麵比較,差異均有統計學意義.不同劑量IVIG時,患兒熱程(MD=-0.28,95％CI:-0.59～0.03,P＞0.05)、皮疹消退(MD =0.18,95％ CI:-0.22～0.59,P＞0.05)、留院時間(MD=-0.12,95％CI:-0.47～0.23,P＞0.05)比較,差異均無統計學意義.結論 在危重癥手足口病患兒的治療中,IVIG能有效縮短髮熱時間、減少留院時間,值得推薦.開展嚴格的試驗設計,多中心、大樣本的臨床試驗有助于進一步明確IVIG在危重癥手足口病治療中的有效性和安全性.
목적 평개정맥용병충구단백(IVIG)치료위중증수족구병적유효성.방법 검색PubMed、MEDLINE、EMBASE、EBSChost、Cochrane도서관、Cochrane림상대조시험고(CENTRAL)、Ovid、중국생물의학문헌수거고、만방수거고、중국지망、유보중문과기기간수거고급소획적삼고문헌、회색문헌,사선소유응용IVIG치료위중증수족구병적림상시험.선택문헌、평개질량、제취자료병교차핵대,채용Rev Man 5.3연건진행Meta분석.결과 납입11편문헌,공967례.분석결과현시:여상규치료조상비,IVIG조환인재총체료효(OR=6.84,95％CI:3.74 ～ 12.52,P＜0.05)、열정[균수차(MD)=-1.94,95％CI:-3.07 ～-0.81,P＜0.05]、류원시간(MD=-4.56,95％CI:-8.95～-0.17,P＜0.05)등방면비교,차이균유통계학의의.불동제량IVIG시,환인열정(MD=-0.28,95％CI:-0.59～0.03,P＞0.05)、피진소퇴(MD =0.18,95％ CI:-0.22～0.59,P＞0.05)、류원시간(MD=-0.12,95％CI:-0.47～0.23,P＞0.05)비교,차이균무통계학의의.결론 재위중증수족구병환인적치료중,IVIG능유효축단발열시간、감소류원시간,치득추천.개전엄격적시험설계,다중심、대양본적림상시험유조우진일보명학IVIG재위중증수족구병치료중적유효성화안전성.
Objective To evaluate the effectiveness of intravenous immunoglobulin (IVIG) in critical hand-foot-mouth disease (HFMD).Methods The data from PubMed, MEDLINE, EMBASE, EBSChost, Cochrane Library, Cochrane Central Register of Controlled Trials, Ovid, China Biology Medicine disc, Wanfang Data, China National Knowledge Infrastructure, Chinese Citation Database, and other references and grey literatures were retrieved, screening out all those related to clinical trials on treating critical HFMD by IVIG.Standard methods of the Cochrane Collaboration were employed to evaluate the methodological quality of the trials.Meta analysis was performed with Rev man 5.3 software.Results Eleven trials including 967 cases were investigated.The meta analysis showed that IVIG had significantly clinical efficacy (OR =6.84,95％ CI:3.74-12.52 ,P ＜ 0.05).IVIG could significantly decrease duration of fever (MD =-1.94,95％ CI:-3.07--0.81 ,P ＜0.05) ,hospitalization time (MD =-4.56,95％ CI:-8.95--0.17,P ＜0.05).There was no significant difference in duration of fever (MD =-0.28,95 ％ CI:-0.59-0.03, P ＞ 0.05), duration of herpes (MD =0.18,95％ CI:-0.22-0.59, P ＞ 0.05), hospitalization time (MD =-0.12,95％ CI:-0.47-0.23, P ＞ 0.05) when the dosage of injection was adjusted.Conclusions IVIG is recommended for treating critical HFMD because it is effective in decreasing the duration of fever and hospitalization.Well designed studies with more sample in multi-center are required in further study to explore the efficacy and safety of IVIG on critical HFMD.
