系统评价长期口服小剂量阿奇霉素对稳定期COPD患者肺功能及临床体征的影响
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篇名: 系统评价长期口服小剂量阿奇霉素对稳定期COPD患者肺功能及临床体征的影响
TITLE:
摘要: 目的:系统评价长期口服小剂量阿奇霉素对稳定期慢性阻塞性肺疾病(COPD)患者肺功能及临床体征的影响,为临床提供循证参考。方法:计算机检索PubMed、Medline、中国期刊全文数据库(CJFD)、中文科技期刊数据库(VIP)、万方数据库,收集长期口服小剂量阿奇霉素用于稳定期COPD的临床随机对照试验(RCT),提取资料并按照改良的Jadad评分表评价质量后,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入13项RCT,合计1 207例患者。Meta分析结果显示,长期口服小剂量阿奇霉素能显著提高稳定期COPD患者1秒用力呼吸容积(FEV1)[SMD=0.78,95%CI(0.62,0.93),P<0.001]、1秒用力呼气量与用力肺活量比值(FEV1%) [SMD=0.81,95%CI(0.61,1.00),P<0.001]、1秒呼出的气体量占肺内总量的百分比(FEV1/FVC) [SMD=3.91,95%CI(2.58,5.24),P<0.001]和6分钟步行距离(6MWD)[SMD=23.74,95%CI(21.20,26.18),P<0.001],显著降低呼吸困难评分[SMD=-1.15,95%CI(-1.60,-0.71),P<0.001]和生活质量评分[SMD= -1.82,95%CI(-2.74,-0.90),P<0.001],减少24 h 痰量[SMD=-18.68,95%CI(-24.79,-12.56),P<0.001],差异均有统计学意义。结论:长期口服小剂量阿奇霉素可以改善稳定期COPD患者肺功能,减轻呼吸困难,减少咳痰量,增加活动耐受力,提高生活质量。
ABSTRACT: OBJECTIVE: To systematically review the effects of long-term oral low-dose of azithromycin on pulmonary function and clinical signs of patients with stable COPD. METHODS: Retrieved from PubMed, Medline, CJFD, VIP and Wanfang database, randomized controlled trials (RCTs) about long-term oral low-doses of azithromycin for stable COPD were collected. After quality evaluation according to modified Jadad scale, Meta-analysis was conducted by Rev Man 5.2 statistical software. RESULTS: A total of 13 RCTs were included, involving 1 207 patients. Meta-analysis showed that, long-term oral low-doses of azithromycin could significantly improve FEV1[SMD=0.78,95%CI(0.62,0.93),P<0.001], FEV1%[SMD=0.81,95%CI(0.61,1.00),P<0.001], FEV1/FVC [SMD=3.91,95%CI(2.58,5.24),P<0.001] and 6MWD[SMD=23.74,95%CI(21.20,26.18),P<0.001] in stable COPD patients,meanwhile significantly reduce dyspnea score [SMD=-1.15,95%CI(-1.60,-0.71),P<0.001], quality of life score [SMD=-1.82,95%CI(-2.74,-0.90),P<0.001] and 24 h sputum volume[SMD=-18.68,95%CI(-24.79,-12.56),P<0.001], with statistical significance. CONCLUSIONS: Long-term oral low-doses of azithromycin can improve pulmonary function, dyspnea,activity tolerance and quality of life in acute exacerbation of COPD patients.
期刊: 2017年第28卷第21期
作者: 董辉,张海滨,吕志坚,马勇
AUTHORS: DONG Hui,ZHANG Haibin,LYU Zhijian,MA Yong
关键字: 阿奇霉素;慢性阻塞性肺疾病;稳定期;肺功能;生活质量;循证研究
KEYWORDS: Azithromycin; COPD; Stable; Lung function; Quality of life; Evidence-based study
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