本刊首页 > 期刊目次 > 不同给药方式治疗慢性阻塞性肺疾病急性加重患者的有效性和安全性文献分析

• 文章 •

不同给药方式治疗慢性阻塞性肺疾病急性加重患者的有效性和安全性文献分析

  • 段榆琳

* 通信作者: 段榆琳, 单位:西南医科大学附属第一人民医院呼吸内一科

摘要


目的 比较糖皮质激素(GCs)吸入给药与静脉给药对治疗慢性阻塞性肺疾病急性加重(AECOPD)患者的有效性和安全性。

方法 纳入已发表的关于GCs治疗AECOPD的所有临床随机对照试验(clinical randomized trial, RCT),试验组为GCs吸入给药,对照组为GCs静脉给药,对治疗有效性指标(FEV1、FEV1/FVC、 PaO2、PaCO2)和不良反应发生风险(ADR)进行meta分析。

结果 共纳入13项RCT(总随机样本量为1333例)。两组患者除PaO2外的其他有效性指标均无显著差异。与静脉组相比,雾化组ADR发生风险降低(RR:0.37,95%CI :0.28-0.49,I2=29%);其中,雾化组患者的血糖紊乱(RR:0.27,95%CI :0.16-0.44,I2=0)、胃肠道反应(RR:0.54,95%CI :0.35~0.83,I2=0)和神经系统反应发生风险(RR:0.20,95%CI :0.07~0.55,I2=0)。

结论 两种给药方式治疗有效性相当,但吸入给药的不良反应发生风险更低。

关键词:糖皮质激素;雾化吸入;静脉给药;慢性阻塞性肺疾病急性加重;有效性;安全性;

ABSTRACT

objective Comparing the differences of efficacy and safety between inhaled glucocorticoid (GCs) and intravenous GCs for the treatment of chronic obstructive pulmonary diseases acute exacerbation (AECOPD). Method We systematically searched related databases for relevant clinical randomized controlled trials (RCT). FEV1, FEV1/FVC, PaO2, PaCO2 and the risk of adverse reaction rate (ADR) were pooled by using the Ren Man 5.3 software. Result A total of 13 RCTs with 1333 randomized patients were included.

Results showed that there was no significant difference in FEV1, FEV1/FVC, PaCO2 and PaO2 with the comparison of inhaled group vs. intravenous group. However, the incidence of ADR in the inhaled group decreased by 63% (RR: 0.37, 95%CI: 0.28~0.49, I2=29%). The risk of occurrence of blood glucose disorder (RR: 0.27, 95%CI:0.16~0.44, I2=0), nervous system reaction (RR: 0.54, 95%CI : 0.35~0.83,I2=0) and gastrointestinal reaction(RR: 0.20, 95%CI : 0.07~0.55, I2=0) in the inhaled group decreased by 73% ,46% and 80%, respectively.

Conclusion   The efficacy of the two administration methods were seem to equally, but the risk of adverse reactions in inhaled group was much lower than intravenous group.

Key words: Glucocorticoid; nebulized inhalation; intravenous administration; acute exacerbation of chronic obstructive pulmonary disease; effectiveness; safety;

引用本文 / How to Cite This Article

段榆琳.不同给药方式治疗慢性阻塞性肺疾病急性加重患者的有效性和安全性文献分析[J]. 国际精神病学杂志, , (): -

参考文献

相关文章