肺炎儿童的系统性皮质类固醇:系统性审查和元分析
Maria Geropeppa1, Panagiota Tsagkli1, Ioanna Papadatou1,2
1From the Immunobiology and Vaccinology Research Laboratory, Infectious Diseases Department "MAKKA," First Department of Paediatrics, "Aghia Sophia" Children's Hospital, Athens Medical School, Athens, Greece.
The Pediatric infectious disease journal
|December 17, 2025
概括
辅助皮质类固醇治疗可以缩短住院时间,减少儿科社区获得性肺炎 (CAP) 发烧持续时间. 虽然安全和可管理,但需要进一步的研究,以优化皮质类固醇在治疗儿童中CAP的使用.
科学领域:
- 儿童传染病 儿童传染病
- 临床药理学 临床药理学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 皮质类固醇是针对特定传染病的治疗方法.
- 在小儿社区获得性肺炎 (CAP) 中,皮质类固醇的疗效和安全性尚未确定.
- 这项研究评估了儿科CAP的辅助皮质类固醇治疗.
研究的目的:
- 评估系统性皮质类固醇作为儿科CAP的辅助治疗的疗效.
- 评估在患有CAP的儿童中使用皮质类固醇的安全性.
- 为了确定皮质类固醇对临床结果的影响,如住院时间和发烧持续时间.
主要方法:
- 在MEDLINE上进行了系统的文献搜索,截至2024年12月31日.
- 包括的研究评估了系统性皮质类固醇与儿科CAP中的抗菌疗法一起.
- 对随机临床试验和观察性研究的数据进行了元分析,评估了异质性和出版偏差.
主要成果:
- 系统性审查包括22篇文章 (N=75,353).
- 对7项研究的元分析显示,在随机试验中,在接受皮质类固醇治疗的儿科CAP患者中,住院时间 (LOS) 和分发时间显著减少 (P=0.001和P<0.001分别).
- 皮质类固醇与更快的放射和临床康复有关,特别是在Mycoplasma pneumoniae和带有喘息的病毒性肺炎中;不良事件很少发生并且可以控制.
结论:
- 辅助皮质类固醇治疗对选定的儿科CAP患者显示出潜在的益处.
- 需要进行进一步的研究,以建立在儿科CAP中使用皮质类固醇的最佳方案.
- 这些发现表明,在特定的儿科CAP病例中可能存在优势,需要进一步调查时间和剂量.
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