A systematic review and meta-analysis of the efficacy and safety of glucocorticoids in the treatment of severe pneumonia

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2025-01-01 DOI:10.1016/j.clinsp.2025.100630

Jingye Liu , Zhiqiang Yang

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引用次数: 0

Abstract

Objectives

To systematically evaluate the efficacy and superiority of glucocorticoids in the treatment of severe pneumonia.

Method

Randomized Controlled Trials (RCTs) on glucocorticoids in the treatment of severe pneumonia were retrieved from CNKI, CBM, China Science and Technology Journal Database (VIP), Wanfang Database, and PubMed as of January 1, 2017. The literature was independently and objectively screened, extracted, and evaluated by two researchers, and a meta-analysis of the extracted data was performed using Revman 5.3 software.

Results

Ten studies that met the inclusion criteria were included, with a cumulative total of 1120 cases. The meta-analysis results confirmed that the observation group was superior to the control group in terms of efficacy rate, temperature recovery time, cough relief time, rale disappearance time, and serum CRP level. There was no statistically significant difference in terms of the incidence of adverse reactions, mortality rate, and reinfection rate between the two groups.

Conclusions

Glucocorticoids showed an obvious clinical efficacy in patients with severe pneumonia. However, due to the small number of included studies and the ambiguity of numerous bias risk assessments, high-quality and large-sample RCTs are still needed to provide corroborating evidence.

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糖皮质激素治疗重症肺炎的有效性和安全性的系统回顾和荟萃分析

目的系统评价糖皮质激素治疗重症肺炎的疗效和优越性。方法检索截至2017年1月1日的CNKI、CBM、中国科技期刊数据库（VIP）、万方数据库和PubMed中关于糖皮质激素治疗重症肺炎的随机对照试验（RCTs）。由两位研究者独立客观地筛选、提取和评价文献，并使用Revman 5.3软件对提取的资料进行meta分析。结果符合纳入标准的研究共纳入10例，累计1120例。meta分析结果证实，观察组在有效率、体温恢复时间、止咳时间、咳嗽消失时间、血清CRP水平等方面均优于对照组。两组患者不良反应发生率、死亡率、再感染率差异无统计学意义。结论糖皮质激素治疗重症肺炎临床疗效显著。然而，由于纳入的研究数量较少，且许多偏倚风险评估存在模糊性，因此仍需要高质量、大样本的随机对照试验来提供确证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.