The Efficacy and Safety of Azitromycin Combined with Purdue Blue in the Treatment of Pediatric Mycoplasma Pneumonia: A Meta-analysis
阿奇霉素联合蒲地蓝治疗小儿支原体肺炎的临床疗效及安全性Meta分析

摘要

目的 评价阿奇霉素联合蒲地蓝治疗小儿支原体肺炎的临床疗效及安全性。方法 计算机检索Cochrane Central Register of Controlled Trials、Joanna Briggs Institute Library、Science、Web of Science、MEDLINE、Pub Med、中国生物医学文献库（CBM）、维普（VIP）、中国知网（CNKI）、万方数据资源系统中关于阿奇霉素联合蒲地蓝治疗小儿支原体肺炎效果的随机对照试验，同时采用滚雪球方法筛选纳入文献的参考文献。由2名研究者进行纳入文献质量评价并提取研究相关的信息，采用软件RevMan5.3版进行Meta分析。结果 纳入8项随机对照试验（RCT），共883例患者。Meta分析结果表明，阿奇霉素联合蒲地蓝治疗组的临床疗效（P＜0.00001），发热消失时间（P＜0.00001），血清炎性因子：白介素-6（IL-6）（P＜0.00001）、白介素-8（IL-8）（P＜0.00001）、C反应蛋白（CRP）（P=0.01）、肿瘤坏死因子（TNF-α）（P＜0.00001）、免疫干扰素（INF-γ）（P＜0.00001），T淋巴细胞亚群CD4+T细胞/CD8+T细胞（P＜0.00001）均显著优于阿奇霉素治疗组；两者在不良反应的发生率（P=0.86），T淋巴细胞亚群：CD3+T细胞（P=0.21）、CD4+T细胞（P=0.81）、CD8+T细胞（P=0.98），血清炎性因子：降钙素原（PCT）（P=0.34）方面比较，差异无统计学意义。结论 采用蒲地蓝辅助阿奇霉素治疗小儿支原体肺炎，可以显著增加临床疗效、缩短发热消失的时间，改善患儿外周血中T淋巴细胞亚群、降低血清炎性因子的浓度，提高机体免疫水平，促进炎症快速吸收。

Abstract

Objective: To evaluate the efficacy and safety of azitromycin combined with Purdue blue in the treatment of pediatric mycoplasma pneumonia.
Methods The Cochrane Central Register of Controlled Trials, Joanna Briggs Institute Library, Web of Science, Science, MEDLINE, PubMed, Web of Knowledge CNKI, Wanfang Data and CBM were searched to collect randomized controlled trials (RCTs) on using azitromycin combined with Purdue blue in the treatment of pediatric mycoplasma pneumonia. The quality of the studies was critically appraised and data were extracted by 2 reviewers independently, and meta-analysis was conducted.
Results A total of 8 RCTs were chosen, involving 883 patients. The results of meta-analysis demonstrated that when used for children with mycoplasma pneumonia, azitromycin combined with Purdue blue could increase efficacy,CD4+ T cell/CD8+ T cell.Antipyretic time, C-reactive protein, Interleukin-6, Interleukin-8 and interferon-γ in azitromycin combined with Purdue blue group were significantly lower than those in azitromycin group. There was no significant difference between the two groups in the aspects of procalcitonin, CD3+ T cell, CD4+ T cell, CD8+ T cell, CD4+ T cell/CD8+ T cell and adverse effects.
Conclusion   Azitromycin combined with Purdue blue can effectively increase efficacy, shorten the time of Antipyretic, improve the T lymphocyte subsets, reduce the concentration of serum inflammatory factors, improve the immune level of the body, and promote the rapid absorption of inflammation in children with mycoplasma pneumonia.