{"title":"地塞米松与泼尼松/泼尼松治疗小儿哮喘急性加重的疗效比较：一项系统综述和荟萃分析","authors":"Haochang Wang, Jiapei Wang, Xuanya He","doi":"10.1080/02770903.2025.2526376","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This updated meta-analysis aimed to investigate the efficacy of dexamethasone compared to prednisone/prednisolone for the management of pediatric patients with acute exacerbation of asthma.</p><p><strong>Data sources: </strong>PubMed, Web of Science, the Cochrane Library, and Scopus were systematically searched from the inception to March 8, 2025.</p><p><strong>Study selections: </strong>Randomized controlled trials comparing the effect of dexamethasone with prednisone/prednisolone on hospital admission, relapse, readmission, length of hospital stay, pediatric respiratory assessment measure (PRAM) score, intensive care unit (ICU) admission, noncompliance, and vomiting among pediatric patients with acute asthma exacerbation were identified. Studies other than randomized controlled trials, studies lacking both groups and those not reporting the outcomes of interest were excluded. A random-effects model was adopted to pool data.</p><p><strong>Results: </strong>Sixteen studies with 1481 individuals in the dexamethasone group and 1436 individuals in the prednisone/prednisolone group were included. No significant differences were found between dexamethasone and prednisone/prednisolone groups in terms of the risk of hospitalization (RR 0.96, 95% CI (0.79, 1.17), I<sup>2</sup> = 0.00%), ICU admission (RR 0.64, 95% CI (0.08, 4.88), I<sup>2</sup> = 0.00%), relapse (RR 0.99, 95% CI (0.71, 1.38), I<sup>2</sup> = 0.00%), hospital readmission (RR 0.90, 95% CI (0.34, 2.35), I<sup>2</sup> = 30.98%), the PRAM score (RR -0.24, 95% CI (-0.54, 0.06), I<sup>2</sup> = 41.30%), the length of hospital stay (RR -2.69 h, 95% CI (-6.91, 1.53), I<sup>2</sup> = 69.50%), and noncompliance (RR 0.47, 95% CI (0.07, 3.01), I<sup>2</sup> = 65.20%). Moreover, dexamethasone decreased the risk of vomiting (RR 0.39, 95% CI (0.25, 0.59), I<sup>2</sup> = 26.62%) compared to prednisone-prednisolone.</p><p><strong>Conclusion: </strong>Dexamethasone was not inferior to prednisolone/prednisone in the management of pediatric asthma exacerbation.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-12"},"PeriodicalIF":1.3000,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The efficacy of dexamethasone compared to prednisone/prednisolone for the management of pediatric patients with acute exacerbation of asthma: a systematic review and meta-analysis.\",\"authors\":\"Haochang Wang, Jiapei Wang, Xuanya He\",\"doi\":\"10.1080/02770903.2025.2526376\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This updated meta-analysis aimed to investigate the efficacy of dexamethasone compared to prednisone/prednisolone for the management of pediatric patients with acute exacerbation of asthma.</p><p><strong>Data sources: </strong>PubMed, Web of Science, the Cochrane Library, and Scopus were systematically searched from the inception to March 8, 2025.</p><p><strong>Study selections: </strong>Randomized controlled trials comparing the effect of dexamethasone with prednisone/prednisolone on hospital admission, relapse, readmission, length of hospital stay, pediatric respiratory assessment measure (PRAM) score, intensive care unit (ICU) admission, noncompliance, and vomiting among pediatric patients with acute asthma exacerbation were identified. Studies other than randomized controlled trials, studies lacking both groups and those not reporting the outcomes of interest were excluded. A random-effects model was adopted to pool data.</p><p><strong>Results: </strong>Sixteen studies with 1481 individuals in the dexamethasone group and 1436 individuals in the prednisone/prednisolone group were included. No significant differences were found between dexamethasone and prednisone/prednisolone groups in terms of the risk of hospitalization (RR 0.96, 95% CI (0.79, 1.17), I<sup>2</sup> = 0.00%), ICU admission (RR 0.64, 95% CI (0.08, 4.88), I<sup>2</sup> = 0.00%), relapse (RR 0.99, 95% CI (0.71, 1.38), I<sup>2</sup> = 0.00%), hospital readmission (RR 0.90, 95% CI (0.34, 2.35), I<sup>2</sup> = 30.98%), the PRAM score (RR -0.24, 95% CI (-0.54, 0.06), I<sup>2</sup> = 41.30%), the length of hospital stay (RR -2.69 h, 95% CI (-6.91, 1.53), I<sup>2</sup> = 69.50%), and noncompliance (RR 0.47, 95% CI (0.07, 3.01), I<sup>2</sup> = 65.20%). Moreover, dexamethasone decreased the risk of vomiting (RR 0.39, 95% CI (0.25, 0.59), I<sup>2</sup> = 26.62%) compared to prednisone-prednisolone.</p><p><strong>Conclusion: </strong>Dexamethasone was not inferior to prednisolone/prednisone in the management of pediatric asthma exacerbation.</p>\",\"PeriodicalId\":15076,\"journal\":{\"name\":\"Journal of Asthma\",\"volume\":\" \",\"pages\":\"1-12\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-07-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Asthma\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/02770903.2025.2526376\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Asthma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02770903.2025.2526376","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：这项更新的荟萃分析旨在探讨地塞米松与强的松/泼尼松龙治疗小儿哮喘急性加重的疗效。数据来源：PubMed， Web of Science, Cochrane Library， Scopus系统检索自研究开始至2025年3月8日。研究选择：确定了比较地塞米松与强的松/泼尼松龙对急性哮喘患儿入院、复发、再入院、住院时间、儿科呼吸评估量表（PRAM）评分、重症监护病房（ICU）入院、不依从性和呕吐的影响的随机对照试验。排除了随机对照试验以外的研究、缺少两组的研究和未报告相关结果的研究。采用随机效应模型汇集数据。结果：纳入16项研究，地塞米松组1481例，强的松/泼尼松组1436例。地塞米松组与泼尼松/泼尼松龙组在住院风险（RR 0.96, 95% CI (0.79, 1.17), I2=0.00%）、ICU入院风险（RR 0.64, 95% CI (0.08, 4.88), I2=0.00%）、复发风险（RR 0.99, 95% CI (0.71, 1.38), I2=0.00%）、再入院风险（RR 0.90, 95% CI (0.34, 2.35), I2=30.98%）、PRAM评分（RR -0.24, 95% CI (-0.54, 0.06), I2=41.30%）、住院时间（RR -2.69小时，95% CI (-6.91, 1.53), I2=69.50%）、不遵规（RR 0.47, 95% CI (0.07, 3.01), I2=65.20%）。此外，与强的松-强的松龙相比，地塞米松降低呕吐风险（RR 0.39, 95% CI (0.25, 0.59), I2=26.62%）。结论：地塞米松治疗小儿哮喘加重的疗效不逊于强的松/泼尼松。
The efficacy of dexamethasone compared to prednisone/prednisolone for the management of pediatric patients with acute exacerbation of asthma: a systematic review and meta-analysis.
Objective: This updated meta-analysis aimed to investigate the efficacy of dexamethasone compared to prednisone/prednisolone for the management of pediatric patients with acute exacerbation of asthma.
Data sources: PubMed, Web of Science, the Cochrane Library, and Scopus were systematically searched from the inception to March 8, 2025.
Study selections: Randomized controlled trials comparing the effect of dexamethasone with prednisone/prednisolone on hospital admission, relapse, readmission, length of hospital stay, pediatric respiratory assessment measure (PRAM) score, intensive care unit (ICU) admission, noncompliance, and vomiting among pediatric patients with acute asthma exacerbation were identified. Studies other than randomized controlled trials, studies lacking both groups and those not reporting the outcomes of interest were excluded. A random-effects model was adopted to pool data.
Results: Sixteen studies with 1481 individuals in the dexamethasone group and 1436 individuals in the prednisone/prednisolone group were included. No significant differences were found between dexamethasone and prednisone/prednisolone groups in terms of the risk of hospitalization (RR 0.96, 95% CI (0.79, 1.17), I2 = 0.00%), ICU admission (RR 0.64, 95% CI (0.08, 4.88), I2 = 0.00%), relapse (RR 0.99, 95% CI (0.71, 1.38), I2 = 0.00%), hospital readmission (RR 0.90, 95% CI (0.34, 2.35), I2 = 30.98%), the PRAM score (RR -0.24, 95% CI (-0.54, 0.06), I2 = 41.30%), the length of hospital stay (RR -2.69 h, 95% CI (-6.91, 1.53), I2 = 69.50%), and noncompliance (RR 0.47, 95% CI (0.07, 3.01), I2 = 65.20%). Moreover, dexamethasone decreased the risk of vomiting (RR 0.39, 95% CI (0.25, 0.59), I2 = 26.62%) compared to prednisone-prednisolone.
Conclusion: Dexamethasone was not inferior to prednisolone/prednisone in the management of pediatric asthma exacerbation.
期刊介绍：
Providing an authoritative open forum on asthma and related conditions, Journal of Asthma publishes clinical research around such topics as asthma management, critical and long-term care, preventative measures, environmental counselling, and patient education.
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