静脉注射用人免疫球蛋白辅助治疗儿童脓毒症疗效的系统评价  

Systematic Review on Efficacy of Intravenous Immunoglobulin in Adjuvant Treatment of Sepsis in Children

作　　者：赵程程[1] 杨开云 刘艺平[1] 颜苗[1] 周艳钢[1] 屈健[1] 罗建权 肖轶雯[1] 杨芳博 张楠 ZHAO Chengcheng;YANG Kaiyun;LIU Yiping;YAN Miao;ZHOU Yan’gang;QU Jian;LUO Jianquan;XIAO Yiwen;YANG Fangbo;ZHANG Nan(Dept.of Pharmacy, the Second Xiangya Hospital of Central South University, Hunan Changsha 410011, China;College of Pharmacy, Central South University, Hunan Changsha 410013, China)

机构地区：[1]中南大学湘雅二医院药学部,湖南长沙410011 [2]中南大学药学院,湖南长沙410013

出　　处：《中国医院用药评价与分析》2018年第12期1606-1609,1617,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：湖南省临床药学研究(生物专项)(No.xy2015004)

摘　　要：目的:系统评价静脉静脉注射用人免疫球蛋白辅助治疗儿童脓毒症的疗效。方法:采用Cochrane系统评价方法,系统搜索中国期刊全文数据库、PubMed和the Cochrane Library等数据库,收集符合纳入标准的静注人免疫球蛋白用于儿童脓毒症的临床对照试验(观察组患儿给予静脉注射用人免疫球蛋白,对照组患儿无干预或给予安慰剂),采用RevMan 5.1进行文献质量评价及荟萃分析(Meta分析)。结果:共纳入18篇文献,合计5 904例患儿。Meta分析结果显示,观察组患儿的死亡率(15.85%)与对照组(15.76%)的差异无统计学意义(OR=1.01,95%CI=0.88～1.17,P=0.86)。亚组分析中,观察组早产儿患儿住院时间(62.25 d)比对照组(64.16 d)短2.68 d,差异有统计学意义(MD=-2.68,95%CI=-4.75～-0.61,P=0.01)。结论:静脉注射用人免疫球蛋白不能降低儿童脓毒症死亡率,但可缩短早产儿患儿的住院时间。OBJECTIVE: To systematically review the efficacy of intravenous immunoglobulin in adjuvant treatment of sepsis in children. METHODS: Cochrane system evaluation was used, CNKI, PubMed and the Cochrane Library were retrieved to collect controlled clinical trials(the observation group was given intravenous immunoglobulin, while the control group was given no intervention or placebo) of itravenous immunoglobulin in treatment of sepsis in children, then RevMan 5.1 was adopted to conduct quality evaluation on literature and Meta analysis. RESULTS: A total of 18 studies were involved, including 5 904 cases of children. Results of Meta analysis indicated that there was no statistical significance(OR=1.01, 95%CI=0.88-1.17, P=0.86) in difference of mortality between observation group(15.85%) and control group(15.76%). Results of subgroup analysis indicated that the hospital stay of premature infants of observation group(62.25 days) was shorter than that of the control group(64.16 days) for 2.68 days, with statistically significant difference(MD=-2.68, 95%CI=-4.75--0.61, P=0.01). CONCLUSIONS: Intravenous immunoglobulin can not reduce the morality of children with sepsis, while can shorten hospital stay for premature infants.

关 键 词：免疫球蛋白 脓毒症 儿童 系统评价 

分 类 号：R979.5[医药卫生—药品]