摘要
目的评价静脉用丙种球蛋白（IVIG）治疗危重症手足口病的有效性。方法检索PubMed、MEDLINE、EMBASE、EBSChost、Cochrane图书馆、Cochrane临床对照试验库（CENTRAL）、Ovid、中国生物医学文献数据库、万方数据库、中国知网、维普中文科技期刊数据库及所获的参考文献、灰色文献，筛选所有应用IVIG治疗危重症手足口病的临床试验。选择文献、评价质量、提取资料并交叉核对，采用Rev Man5．3软件进行Meta分析。结果纳入11篇文献，共967例。分析结果显示：与常规治疗组相比，IVIG组患儿在总体疗效（OR=6．84，95％CI：3．74～12．52，P〈0．05）、热程[均数差（MD）=-1．94，95％CI：-3．07～-0．81，P〈0．05]、留院时间（MD=-4．56，95％CI：-8．95～-0．17，P〈0．05）等方面比较，差异均有统计学意义。不同剂量IVIG时，患儿热程（MD=-0．28，95％CI：-0．59～0．03，P〉0．05）、皮疹消退（MD=0．18，95％CI：-0．22～0．59．P〉0．05）、留院时间（MD=-0．12，95％CI：-0．47～0．23，P〉0．05）比较，差异均无统计学意义。结论在危重症手足口病患儿的治疗中，IVIG能有效缩短发热时间、减少留院时间，值得推荐。开展严格的试验设计，多中心、大样本的临床试验有助于进一步明确IVIG在危重症手足口病治疗中的有效性和安全性。
Objective To evaluate the effectiveness of intravenous immunoglobulin （IVIG） in critical hand - foot - mouth disease （HFMD）. Methods The data from PubMed,MEDLINE,EMBASE,EBSChost,Cochrane Library, Coehrane Central Register of Controlled Trials, Ovid, China Biology Medicine disc, Wanfang Data, China National Knowledge Infrastructure, Chinese Citation Database, and other references and grey literatures were retrieved, screening out all those related to clinical trials on treating critical HFMD by IVIG. Standard methods of the Cochrane Collaboration were employed to evaluate the methodological quality of the trials. Meta analysis was performed with Rev man 5.3 software. Results Eleven trials including 967 cases were investigated. The meta analysis showed that IVIG had significantly clinical efficacy （ OR = 6. 84,95 % CI：3.74 - 12.52,P 〈 0. 05）. IVIG could significantly decrease duration of fever （MD = - 1.94,95% CI： -3.07 - -0. 81 ,P 〈0.05） ,hospitalization time （MD = -4. 56,95% CI： - 8.95 - -0. 17 ,P 〈0.05）. There was no significant difference in duration of fever （MD = - 0.28,95 % CI： - 0. 59 - 0.03, P 〉 0.05 ）, duration of herpes （MD =0.18,95% CI： -0.22 -0.59,P 〉0. 05） ,hospitalization time （MD = -0.12,95% CI： -0.47 -0.23,P 〉 0. 05） when the dosage of injection was adjusted. Conclusions IVIG is recommended for treating critical HFMD because it is effective in decreasing the duration of fever and hospitalization. Well designed studies with more sample in multi - center are required in further study to explore the efficacy and safety of IVIG on critical HFMD.
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2015年第22期1716-1720,共5页
Chinese Journal of Applied Clinical Pediatrics
基金
南京医科大学科技发展基金面上项目（2011NJMU141）
江苏省临床医学科技专项（BL2014008）
关键词
手足口病
静脉用丙种球蛋白
随机对照试验
系统评价
Meta分析
Hand - foot - mouth disease
Intravenous immunoglobulin
Randomized controlled trial
Systematic review
Meta analysis
