在急性喘恶化儿童口服系统性皮质类固醇:一个系统性审查和网络元分析
Shunsuke Amagasa1, Shu Utsumi2, Kie Okajima3
1Department of Emergency and Transport Medicine, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan amagasa0828@gmail.com.
Archives of disease in childhood
|June 8, 2025
概括
短期口服德克萨 (DEXA) 和较长时间的普雷迪尼索隆 (PSL) 疗程在儿童喘恶化中表现出类似的疗效. 这一发现表明,DEXA可能是治疗儿科喘爆发的可行替代方案.
科学领域:
- 儿科肺病学 儿科肺病学
- 药理学 药理学是指药理学的学科.
- 基于证据的医学基于证据的医学.
背景情况:
- 儿童喘恶化需要有效的治疗.
- 皮质类固醇是主要的支柱,但最佳方案 (类型,剂量,持续时间) 仍在争论中.
- 了解疗效差异对于临床决策至关重要.
研究的目的:
- 为了比较各种口服皮质类固醇治疗方案对儿科喘恶化的疗效.
- 根据皮质类固醇类型,剂量和持续时间来确定复发率的潜在差异.
主要方法:
- 随机对照试验 (RCT) 的系统审查和网络元分析,至2024年3月.
- 包括以口服皮质类固醇治疗21岁以下患者喘恶化为重点的RCT.
- 与六种特定疗法进行比较,包括德甲 (DEXA) 和普雷迪尼索隆 (PSL),首要结果是14天内复发.
主要成果:
- 分析了11项涉及2353名患者的研究.
- 在6个比较的皮质类固醇治疗方案中,没有发现复发率的显著差异.
- 证据确定性低至非常低,具体比较显示风险比率接近1.
结论:
- 通常使用的皮质类固醇疗法在急性儿童喘恶化中表现出相似的疗效.
- 短期口服德克萨米他 (DEXA) 是潜在的可接受的替代方案,比较长时间的普雷迪尼索隆 (PSL) 疗程.
- 由于证据的确定性较低,需要进一步进行高质量的研究.
相关概念视频
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
1.5K
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
1.5K
COPD: Management Using Bronchodilators and Corticosteroids
741
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
741
Asthma: Pathogenesis and Management
1.2K
Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
1.2K
Asthma-IV: Diagnostic and Management
3.1K
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
3.1K
Asthma-II: Pathophysiology and Classification
4.1K
Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
4.1K
Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
1.7K
Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
1.7K


