儿童卡氏肺囊虫病药物治疗循证指南的系统评价  

Evidence-based Guidelines on Medication for Children with Pneumocystosis: A Systematic Review

作　　者：潘振宇[1] 李洋[1] 武冬梅[1] 熊凤梅[1] 李媛[1] 成华[1] 张伶俐[2,3] 梁毅[2,3] 李幼平[4] 

机构地区：[1]西安市儿童医院药剂科,西安710003 [2]四川大学华西第二医院药学部,成都610041 [3]四川大学华西第二医院循证药学中心,成都610041 [4]四川大学华西医院中国循证医学中心,成都610041

出　　处：《中国循证医学杂志》2015年第2期159-164,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价儿童卡氏肺囊虫病循证指南的质量,比较药物治疗方案异同,为临床应用提供参考。方法计算机检索TRIP、Pub Med、CNKI、VIP、Wan Fang Data、CBM及美国国家指南文库(U.S National Guideline Clearinghouse,NGC)和国际指南联盟(Guidelines International Network,GIN),纳入儿童卡氏肺囊虫病的循证指南,而后使用AGREEⅡ工具评价纳入指南的方法学质量,分析比较各指南推荐的异同。结果共纳入3个循证指南,包括美国2个,国际学术组织1个。其中1个指南针对儿童,另2个适用于不同年龄段儿童和成人。AGREEⅡ评分结果显示,在六大领域的评分中,各指南的范围和目的、参与人员、制定的严谨性、清晰性和编辑的独立性得分均>60%,但适用性得分仅分别为46%、25%和31%。此外,各指南证据分级推荐系统不一致,药物治疗推荐意见存在差异。结论现有儿童卡氏肺囊虫病循证指南整体质量不高,证据质量和推荐强度标准尚需统一,目标人群和推荐意见存在一定差异。Objective To systematically review quality of evidence-based pneumocystosis guidelines for children, compare the differences and similarities among recommendations, and to provide references for clinical application. Methods Databases such as TRIP, PubMed, CNKI, VIP, WanFang Data, CBM, U.S National Guideline Clearinghouse （NGC）, and Guidelines International Network （G/N） were searched to collect evidence-based guidelines on medication therapy for children with pneumocystosis. Methodological quality of included guidelines was evaluated according to the AGREE II instrument, and the differences and similarities among recommendations were compared. Results A total of 3 evidence-based guidelines concerning children with pneumocystosis were included, of which, 2 were made by the USA and 1 by international academic organizations. Only 1 guideline was especially suitable for children, while others were for children of different ages and adults. The results of AGREE II scoring showed that, among 6 domains which were rated using the AGREE II instrument, ＂scope and purpose＂, ＂stakeholder involvement＂, ＂rigor of development＂, ＂clarity and presentation＂ and ＂editorial independence＂ were scored more than 60%; while ＂applicability＂ was only scored 46%, 25% and 31%. Besides, the grading of evidence and grading of recommendations were different. The medication recommendations of different guidelines were not the same. Conclusion The quality of 3 guidelines is not high, and the grading of evidence and the strength of recommendation are still needed to be unified. The target population and the recommendations in the guidelines are different.

关 键 词：卡氏肺囊虫 儿童 循证指南 系统评价 

分 类 号：R725.3[医药卫生—儿科] R-03[医药卫生—临床医学]