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-  2017 

全身应用糖皮质激素对慢性阻塞性肺疾病急性加重患者治疗效果的系统评价

DOI: doi:10.7507/1671-6205.201607019

Keywords: 慢性阻塞性肺疾病, 糖皮质激素, 系统评价, Meta分析

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Abstract:

目的 系统评价全身应用糖皮质激素对慢性阻塞性肺疾病(简称慢阻肺)急性加重患者治疗的有效性及安全性,以期为临床慢阻肺急性加重患者糖皮质激素给药方式的选择提供证据。 方法 计算机检索 PubMed、EMbase、The Cochrane Library(2015 年第 6 期)、Wanfang Data、CBM、CNKI,查找有关全身应用糖皮质激素对慢阻肺急性加重患者治疗效果的随机对照临床试验(RCT)。检索时限均为建库至 2015 年 7 月。由两位研究者严格按照纳入与排除标准独立筛选文献、提取资料和评价质量,并相互交叉核对结果,如遇分歧则讨论解决,若无法达成一致,则交由第三位研究者协助裁定。数据提取完毕后采用 RevMan 5.3 软件进行 Meta 分析。 结果 最终纳入 11 个 RCT,共计 1 298 例患者。Meta 分析结果显示:糖皮质激素组治疗成功率显著高于对照组( RR=1.11,95% CI 1.01~1.21, P=0.02);ICU 及急诊室糖皮质激素组治疗成功率与对照组相比差异无统计学意义( RR=0.98,95% CI 0.90~1.08, P=0.74; RR=1.19,95% CI 0.84~1.69, P=0.34)。 结论 全身应用糖皮质激素可显著提高治疗成功率,但对急诊室、ICU 患者治疗成功率的影响尚待评估。受样本量及原始资料的限制,本研究尚需更多高质量研究加以验证

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