系统性皮质类固醇治疗两岁以下儿童毛细支气管炎:一项系统综述

E. Heidari, M. Emadzadeh, E. Khodashenas, Farideh Najm Sarvari, H. Ahanchian, A. Heidari, Mahdi Mottaghi
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引用次数: 0

摘要

简介:毛细支气管炎是一岁以下呼吸道感染的主要原因。本系统综述旨在评估全身性皮质类固醇治疗首次住院年龄小于2岁的儿童毛细支气管炎的有效性。方法:截至2019年8月,通过检索PubMed、Scopus、Web of Science、Cochrane Library等数据库进行系统评价。在检索到的研究中评估了系统性皮质类固醇对两岁以下毛细支气管炎儿童的影响的随机临床试验。研究的质量根据Jadad量表进行评估。结果:本系统综述纳入了3项研究。在两项研究中,使用地塞米松和安慰剂,在一项研究中,使用强的松龙。在一项研究中,使用地塞米松与安慰剂相比,呼吸窘迫的缓解速度更快,呼吸窘迫综合征持续时间更短,氧疗时间缩短,住院时间缩短。在另一项研究中,与对照组相比,接受地塞米松治疗的儿童在临床评分、呼吸频率和肺功能方面没有显著差异。在另一项研究中,在两周内使用强的松龙导致鼻炎、喘息、呼吸问题、夜间呼吸道症状和咳嗽的部分改善。然而,12个月后,强的松龙治疗组与对照组之间没有明显差异。结论:尽管呼吸道症状有所改善,但关于全身皮质类固醇治疗两岁以下儿童毛细支气管炎的有效性的证据很少。因此,在这方面需要设计良好的大样本量随机临床试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Systemic Corticosteroids for Bronchiolitis in Children Aged Less than Two Years: A Systematic Review
Introduction: Bronchiolitis is the main cause of lower respiratory tract infection during the first year of life. This systematic review aimed to assess the effectiveness of systemic corticosteroids in the treatment of bronchiolitis in children aged less than two years during their first hospitalization.Methods: This systematic review was conducted via searching in databases such as PubMed, Scopus, Web of Science, and Cochrane Library until August 2019. Randomized clinical trials regarding the effects of systemic corticosteroids on children with bronchiolitis aged less than two years were evaluated in the retrieved studies. The quality of the studies was assessed based on the Jadad scale. Result: Three studies were included in this systematic review. In two studies, dexamethasone versus placebo were used, and in one study, prednisolone was applied. In one study, use of dexamethasone versus placebo resulted in the faster resolution of respiratory distress, shorter duration of respiratory distress syndrome, reduced oxygen therapy time, and reduced length of hospital stay. In another study, children receiving treatment with dexamethasone had no significant difference in the clinical score, respiratory rate, and pulmonary function compared to the control group. In another study, use of prednisolone within two weeks led to the partial improvement of rhinitis, wheezing, breathing problems, nocturnal respiratory symptoms, and coughing. However, no significant difference was observed between the prednisolone treatment and control groups after 12 months.Conclusion: Despite the improvements in respiratory symptoms, evidence is scarce regarding the effectiveness of systemic corticosteroids in the treatment of bronchiolitis in children aged less than two years. Therefore, well-designed randomized clinical trials on large sample sizes are required in this regard.
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