长期使用阿奇霉素对稳定期慢性阻塞性肺疾病疗效的系统评价被引量：6

Efficacy and safety of long-term use of azithromycin in treatment of chronic obstructive pulmonary disease in stable stage:a meta-analysis

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摘要目的:系统评价长期使用阿奇霉素对稳定期慢性阻塞性肺疾病(简称慢阻肺)的疗效。方法:计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、CNKI和WanFang Data数据库,搜集有关长期使用阿奇霉素对稳定期慢阻肺病疗效的随机对照试验(RCT),检索时限均为从建库至2019年8月1日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R studio(version 3.5.1)软件进行Meta分析。结果:共纳30个RCT,包括2726例患者。Meta分析结果显示:与对照组相比,长期使用阿奇霉素可改善慢阻肺患者的肺功能:使用支气管扩张剂后第一秒用力呼气量/用力肺活量(FEV1/FVC)增加[MD=0.85,95%CI(0.46,1.24),P<0.01]、第一秒用力呼气量FEV1(L)增加[MD=0.81,95%CI(0.45,1.17),P<0.01]及第一秒用力呼气量比预计值FEV1%pred增加[MD=0.60,95%CI(0.31,0.88),P<0.01]、增加6 min步行试验距离[MD=1.83,95%CI(1.13,2.54),P<0.01]、降低圣乔治呼吸问卷评分(SGRQ)[MD=-0.88,95%CI(-1.70,-0.08),P=0.03],差异均有统计学意义。结论:长期使用阿奇霉素能有效改善稳定期慢阻肺患者肺功能、运动耐量及生活质量。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。 Objective:To systematically review the efficacy of long-term use of azithromycin in the treatment of chronic obstructive pulmonary disease(COPD)in stable stage.Methods:PubMed,Embase,The Cochrane Library,Web of Science,CNKI,and Wanfang Data were searched for randomized controlled trials(RCTs)of long-term use of azithromycin in the treatment of COPD in stable stage published up to August 1,2019.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of included studies,and then R studio(version 3.5.1)was used to perform the meta-analysis.Results:A total of 30 RCTs with 2726 patients were included.The results of the meta-analysis showed that compared with the control group,the long-term azithromycin group had significant improvement in pulmonary function,with significant increases in ratio of forced expiratory volume in 1 second to forced vital capacity(mean difference[MD]=0.85,95%confidence interval[CI]:0.46~1.24,P<0.01),forced expiratory volume in 1 second(MD=0.81,95%CI:0.45~1.17,P<0.01),predicted percentage of forced expiratory volume in 1 second(MD=0.60,95%CI:0.31~0.88,P<0.01),and 6-minute walk test distance(MD=1.83,95%CI:1.13~2.54,P<0.01)and a significant reduction in the score of St George’s Respiratory Questionnaire(MD=-0.88,95%CI:-1.70 to-0.08,P=0.03).Conclusion:Longterm use of azithromycin can effectively improve COPD patients’pulmonary function,exercise tolerance,and quality of life.Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.

作者吴雨宸梁宗安 WU Yuchen;LIANG Zongan(Department of Respiratory and Critical Care Medicine,West China Hospital,Sichuan University,Chengdu 610041,Sichuam Province China)

机构地区四川大学华西医院呼吸与危重症医学科

出处《西南医科大学学报》 2020年第1期1-9,共9页 Journal of Southwest Medical University

基金国家重点研发计划项目(2016YFC1304303)。

关键词阿奇霉素慢性阻塞性肺疾病系统评价 META分析随机对照试验 Azithromycin Chronic obstructive pulmonary disease Systematic review Meta-analysis Randomized controlled trial

分类号 R563.3 [医药卫生—呼吸系统]

作者简介第一作者:吴雨宸,住院医师,硕士生;通信作者:梁宗安,主任医师,教授,博士生导师。Email:liangza@scu.edu.cn。