【摘要】 目的评价不同剂量糖皮质激素治疗重症手足口病的有效性和安全性。方法检索中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)和万方数据库,采用RevMan 5.3软件进行资料分析。结果纳入24篇文献,共2730名患者。仅有5篇文献提及随机分配方法,所有研究均未提及分配隐藏、盲法及失访情况。Meta分析结果显示,小剂量糖皮质激素组(小剂量组)较不使用激素组(无激素组)可有效缩短患者发热时间(P<0.01)、住院时间(P<0.01)和神经系统受累时间(P<0.05)。而大剂量糖皮质激素(大剂量组)较小剂量组仅可缩短神经系统受累时间(P<0.00001);而两组间,肺出血和肺水肿发生率均无统计学差异。结论使用小剂量糖皮质激素可有效缩短重症手足口病患者的发热时间、住院时间和神经系统受累时间,而大剂量组较小剂量组优势不明显。由于本研究纳入文献数量和质量的限制,可能影响结果的准确性,故结论应谨慎对待。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of different doses of glucocorticoid in the treatment of severe hand,foot and mouth disease. Methods CNKI,VIP and Wanfang database were searched. The data were analyzed by RevMan 5.3 software. Results A total of 2377 patients in 24 articles met the inclusion criteria. Only five studies refer to the random assignment methods,all of the trials did not mention the distribution of hidden,blind and the lost situation. Meta-analysis datas showed that there were significant differences between the low doses of glucocorticoid groups and the glucocorticoid groups. Using low doses of glucocorticoid may shorten the fever duration(P<0.01),Hospitalization time(P<0.01) and the time of nervous system involvement(P<0.05). Compared with the low dose groups,using high dose glucocorticoid only rduce the duration of nervous system involvement(P<0.00001). In addition,the results of this study suggest that the incidence of the pulmonary hemorrhage and pulmonary edema between high-dose and low-dose groups was not statistically significant. Conclusion The use of low-dose glucocorticoid may effectively shorten the duration of fever,hospitalization and nervous system involvement in patients with severe hand,foot and mouth disease. However,compared with the low-dose groups,the advantages of high-dose groups were not obvious. The limitations of the number and quality of the literatures included in this study may affect the accuracy of the results,so the conclusions should be treated with caution.更多还原