恢复期血浆及免疫球蛋白治疗严重急性呼吸综合征疗效的系统性评价  被引量:5

Effect of convalescent plasma and immunoglobulin on patients with severe acute respiratory syndrome:a systematic review

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作  者:朱甜甜 徐爱晖[2] 白晓洁 何媛媛 张泓[1] Zhu Tiantian;Xu Aihui;Bai Xiaojie;He Yuanyuan;Zhang Hong(Department of Emergency,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui,China;Department of Respiration and Critical Care Medicine,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui,China)

机构地区:[1]安徽医科大学第一附属医院急诊科,合肥230022 [2]安徽医科大学第一附属医院呼吸与危重症医学科,合肥230022

出  处:《中华危重病急救医学》2020年第4期435-438,共4页Chinese Critical Care Medicine

基  金:国家卫生行业科研专项(201302003);安徽医科大学医学人文研究中心新冠肺炎疫情防控研究应急项目(YJSK202012)。

摘  要:目的系统性分析恢复期血浆及免疫球蛋白对严重急性呼吸综合征(SARS)的疗效,以期为使用恢复期血浆及免疫球蛋白治疗新型冠状病毒肺炎(简称新冠肺炎)提出建议。方法检索PubMed、Cochrane Library、Web of Science、Embase、中国知网、维普、万方及CBM数据库,从2002年11月至2020年3月发表的有关恢复期血浆及免疫球蛋白治疗SARS的相关临床研究。由2名研究者独立筛选文献、提取资料,使用英国国立健康和临床优化研究所病例系列研究质量评分表进行偏倚评估,并对结果进行系统性评价。结果最终纳入10项临床研究,包括212例患者。4篇为病例分析,5篇为病例报告,1篇为病例对照研究;纳入文献质量较低。系统性分析显示,有107例患者在治疗过程中使用了恢复期血浆,16例使用了免疫球蛋白,明确未接受上述两种方法治疗者49例,余40例分组不明。恢复期血浆和免疫球蛋白治疗能改善SARS患者症状,降低病死率(共死亡12例),使大部分SARS患者病情好转;而未接受上述两种方法治疗患者中死亡11例。结论恢复期血浆及免疫球蛋白可有效治疗SARS患者。但由于研究质量较低,缺乏对照,故建议现阶段使用恢复期血浆及免疫球蛋白治疗新冠肺炎患者应持谨慎态度。Objective To systematically review evidence for the effect of convalescent plasma and immunoglobulin on treatment of severe acute respiratory syndrome(SARS),and further provide advice on the treatment of coronavirus disease 2019(COVID-19).Methods Clinical studies of convalescent plasma and immunoglobulin in the treatment of SARS were collected from a variety of databases such as PubMed,Cochrane Library,Web of Science,Embase,CNKI,VIP,Wanfang,and CBM from November 2002 to March 2020.Two researchers independently screened the literature,extracted the data,and assessed the risk of bias based on the national institute for health and clinical excellence case series quality scale,and systematically evaluated the results.Results A total of 10 clinical studies,including 212 patients,were eventually included.There were 4 case series studies,5 case reports and 1 case-control study.Most studies were with low or very low quality.The systematic analysis showed that 107 patients administered convalescent plasma and 16 patients used immunoglobulin during the treatment of SARS.Forty-nine patients were definitely not treated with the above two methods,and the remaining 40 patients were not reported clearly.The treatment of convalescent plasma and immunoglobulin could both improve the symptoms and reduce the mortality(12 died),and most SARS patients got better,while 11 SARS patients who did not receive the above therapies died.Conclusions Convalescent plasma and immunoglobulin were effective on relieving symptoms of SARS patients.However,due to low quality and lacking of control group,convalescent plasma and immunoglobulin should be used with caution to treat COVID-19 patients.

关 键 词:严重急性呼吸综合征 新型冠状病毒肺炎 恢复期血浆 免疫球蛋白 疗效 

分 类 号:R511.9[医药卫生—内科学]

 

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