【摘要】 目的:评价以不同溶媒雾化吸入沙丁胺醇在哮喘急性发作治疗中的疗效差异。方法:对已发表的比较以等渗硫酸镁溶液与生理盐水为溶媒吸入沙丁胺醇对哮喘急性发作疗效的临床随机对照试验结果进行M eta分析。结果:对入选5项研究219例哮喘急性发作患者的M eta分析表明,以等渗硫酸镁溶液与生理盐水作为雾化溶媒相比较,患者的肺功能指标有显著改善[合并标准化均数差为0.55(95%C I 0.28~0.83),P<0.001]。进一步分层分析提示,第1秒钟用力呼气容积占预计值的百分数(FEV1%)<30%的重度急性发作患者其FEV1的改善更为显著[FEV1的加权均数差为0.72 L(95%C I 0.30 L~1.14 L),P<0.01]。比较两种溶媒对患者生命体征的影响无显著差异。未发现以等渗硫酸镁作溶媒可降低对急诊哮喘急性发作患者的住院风险[合并RR为0.64(95%C I 0.38~1.08),P>0.05]。结论:与生理盐水比较,以等渗硫酸镁溶液作为溶媒雾化吸入沙丁胺醇是一种更为有效改善哮喘重度急性发作患者肺功能的治疗方法。该疗法可否降低急诊哮喘患者的住院风险及其使用的安全性有待进一步研究评估。更多还原

【Abstract】 Objective: To assess the efficacy of two vehicles for nebulized salbutamol in treatment of asthma exacerbations with Meta-analysis.Methods: All relevant randomized controlled clinical trials（RCT） with isotonic magnesium sulphate and saline as vehicles for inhaled salbutamol in treatment of asthma exacerbations were searched.A Meta-analysis was performed to evaluate the results of the two therapies.Results: Five relevant RCTs from literature were collected and total 219 cases were included for analysis.The meta-analysis indicated that the significant improvements were obtained from isotonic magnesium sulphate as a vehicle for nebulized salbutamol,in comparison with saline [pooled standardized mean difference（SMD）=0.55（95% CI 0.28⁰.83）,P<0.001].By further subgroup analysis,this change was properly significant in the subgroup of severe patients with their baseline FEV₁%<30% [FEV₁ weighted mean difference（WMD）=0.72 L（95% CI 0.30 L¹.14 L）,P<0.01].The pooled results of vital signs between two vehicles did not demonstrate statistical significance.Overall,the risk of admission to hospital was not statistically reduced in patients using magnesium sulphate,who presented to the emergency department with an asthma exacerbation [pooled RR=0.64（95% CI 0.38¹.08）,P>0.05].Conclusion: Compared with saline,the use of isotonic magnesium sulfate as an adjuvant to nebulize salbutamol is a beneficial therapy with improving spirometric airway function in the severe asthma exacerbation.更多还原