免疫佐剂治疗儿童呼吸道感染临床疗效的Meta分析
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李治纲,E-mail:1441758443@qq.com;Tel:13899156109

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自治区自然基金(No:2014211C102)


Systematic review of immune adjuvant for recurrent respiratory infection of children
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    摘要:

    目的  采用Meta分析方法评价免疫佐剂治疗儿童反复呼吸道感染的临床疗效和安全性。方法  计算机检索EMBASE(1974年9月-2013年9月)、PUBMED(1966~2013年)、The Cochrane Register of Controlled Trials(2013年第1期)和VIP(1989年9月~2013年9月),万方数据库(1994年1月-2013年9月),CNKI(1979年1月-2013年9月),手工检索最近1年国内已发表的相关论文及会议资料。按照纳入与排除标准选择文献、提取资料和评价纳入研究的方法学质量后,采用Cochrane协作网提供的RevMan 5.3软件进行Meta分析。结果  共纳入13个研究,1 088例患儿。Meta分析结果显示,免疫佐剂+常规治疗组能提高患儿的T淋巴细胞亚群CD3(WMD=7.97;95%CI:5.6,10.34;P =0.000)、CD4(WMD=5.44;95%CI:1.27,9.6;P =0.010)水平,提高免疫球蛋白IgA(WMD=0.43;95%CI:0.08,0.77;P =0.010),IgG(WMD=1.07;95%CI:0.25,1.89,P = 0.000)水平;延缓RRI发作天数(WMD=-5.14;95%CI=6.72,3.56;P =0.040);对CD8(WMD=0.7;95%CI: 0.19,1.59;P =0.130)及CD4/CD8(WMD=0.25;95%CI:0.04,0.45;P =0.130)及免疫球蛋白IgM(WMD=0.04;95%CI:-0.05,0.12;P =0.370)和不良反应发生率(WMD=1.5;95%CI:0.52,4.28;P =0.450)试验组与对照组之间差异无统计学意义。结论  基于现有临床证据,免疫佐剂联合常规治疗可有效治疗儿童反复呼吸道感染,安全性好。但由于纳入研究数量少,研究质量不统一,本结论尚需要更多大样本、高质量的RCT予以证实。

    Abstract:

    Objective To evaluate the clinical curative effect of immune adjuvant treatment in treating children recurrent respiratory tract infections by meta analysis method.  Methods  EMBASE (1974.9-2013.9), PUBMED (1966~2013), the Cochrane Register of Controlled Trials (2013.1) and VIP (1989.9-2013.9), WanFang Data (1994.1-2013.9), CNKI (1979.1-2013.9) were retrived by using computer. And domestic published information on papers and conference in recent 1 year was manually retrived. Literature were selected according the inclusion and exclusion criteria. Information and evaluation into the study of methodological quality was extracted using the Cochrane Revman5.3 software for Meta analysis. Results Participants included 13 researches, 1088 cases of pediatric patients. Meta analysis showed that immune adjuvant combined with conventional treatment group can improve the patient's immune adjuvant T-lymphocyte subsets CD3 (WMD = 7.97, 95%CI = 5.6, 10.34, P = 0.000), CD4 (WMD = 5.44, 95%CI=1.27, 9.6, P = 0.010) and improve the immunoglobulin IgA (WMD = 0.43, 95%CI = 0.08, 0.77, P = 0.010),IgG (WMD = 1.07, 95%CI = 0.25, 1.89, P =0.010), and can delay the onset of several days of RRI (WMD = -5.14, 95%CI : 6.72, 3.56, P = 0.040). The CD8 (WMD = 0.7, 95%CI : 0.19, 1.59, P = 0.130) and CD4/CD8 (WMD = 0.25, 95%CI : 0.04, 0.45, P = 0.130), IgM (WMD = 0.04, 95%CI : -0.05, 0.12, P = 0.370) and the incidence of adverse reactions (WMD = 1.5, 95%CI : 0.52, 4.28, P = 0.450) had no statistically significant difference between experimental group and control group. Conclusions The results of Meta-analysis indicate that immune adjuvant combined with conventional treatment can reduce the frequency of recurrent respiratory infection with safety. Howerver, due to the number and quality of included studies, more large-scale and high-quality RCTs are needed.

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郑丽丽,姚莉,范芳芳,胡兰,李治纲.免疫佐剂治疗儿童呼吸道感染临床疗效的Meta分析[J].中国现代医学杂志,2016,(16):81-87

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  • 收稿日期:2015-11-18
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  • 在线发布日期: 2016-08-31
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