| 引用本文: | 刘克锋,卢晓静,杨勇杰,张旭锋,鲁春云,张晓坚,康建.静注人免疫球蛋白治疗重症和危重症COVID-19患者有效性和安全性的Meta分析[J].中国现代应用药学,2024,41(22):76-85. |
| liukefeng,Lu Xiaojing,Yang Yongjie,Zhang Xufeng,Lu Chunyun,Zhang Xiaojian,Kang jian.Meta-analysis of the effectiveness and safety of intravenous human immunoglobulin in the treatment of severe and critical COVID-19 patients[J].Chin J Mod Appl Pharm(中国现代应用药学),2024,41(22):76-85. |
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| 静注人免疫球蛋白治疗重症和危重症COVID-19患者有效性和安全性的Meta分析 |
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刘克锋, 卢晓静, 杨勇杰, 张旭锋, 鲁春云, 张晓坚, 康建
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郑州大学第一附属医院
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| 摘要: |
| 目的:系统评价静注人免疫球蛋白(IVIG)治疗重症和危重COVID-19患者有效性和安全性,以期为临床用药提供参考。方法:计算机检索PubMed、Embase、Cochrane图书馆、中国知网和万方数据库,收集IVIG对比常规治疗用于重症和危重症COVID-19患者的随机对照试验(RCT)或者观察性研究,检索时限从建库至2023年1月。由两名研究者独立筛选文献、提取资料后采用Cochrane 5.1.0偏倚风险评估工具和Newcastle-Ottawa Scale评价量表对纳入文献质量进行评价,并用GRADE方法对证据体进行质量分级,采用Rev Man 5.3软件和Stata 14.0软件进行Meta分析。结果:共纳入5篇RCT和11篇队列研究涉及3803例重症和危重COVID-19患者。Meta分析结果显示,IVIG的治疗对于重症或危重症COVID-19患者总体死亡率略低于对照组[RR=0.90,95%CI(0.75,1.08),P=0.26],但是差异没有统计学意义；总体住院时间略高于对照组[MD=1.46,95%CI(-3.16,6.08),P=0.54],差异没有统计学意义；总体ICU停留时间略高于对照组[MD=0.11,95%CI(-1.32,1.54),P=0.88],差异没有统计学意义；两组不良反应发生率相当[RR=1.09,95%CI(0.89,1.34),P=0.40]。结论:使用IVIG并不能降低重症或危重症COVID-19患者的死亡率、住院时间和ICU停留时间,因此并不推荐临床使用IVIG治疗重症或危重症COVID-19患者。 |
| 关键词: 静注人免疫球蛋白 重症 危重症 COVID-19 Meta分析 |
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| Meta-analysis of the effectiveness and safety of intravenous human immunoglobulin in the treatment of severe and critical COVID-19 patients |
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liukefeng, Lu Xiaojing, Yang Yongjie, Zhang Xufeng, Lu Chunyun, Zhang Xiaojian, Kang jian
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he First Affiliated Hospital of Zhengzhou University
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| Abstract: |
| ABSTRACT: OBJECTIVE To systematically evaluate the efficacy and safety of intravenous human immunoglobulin (IVIG) for the treatment of severe and critical COVID-19 patients, with a view to providing a reference for clinical use. METHODS PubMed, Embase, Cochrane Library, CNKI and Wanfang database were searched to collect randomized controlled trials (RCTs) or observational studies of IVIG compared with conventional treatment for patients with severe and critical COVID-19, and the search time frame was from the establishment of the database to January 2023. The quality of the included literature was evaluated by two investigators who independently screened the literature and extracted information using the Cochrane 5.1.0 risk of bias assessment tool and the Newcastle-Ottawa Scale evaluation scale, and the body of evidence was graded for quality using the GRADE method. Meta-analysis was performed using Rev Man 5.3 software and Stata 14.0 software. RESULTS A total of 5 RCTs and 11 cohort studies involving 3803 patients with severe and critically ill COVID-19 were included. Meta-analysis results showed that IVIG treatment had a slightly lower overall mortality rate than controls for patients with severe or critically COVID-19 [RR=0.90, 95% CI (0.75, 1.08), P=0.26], but the difference was not statistically significant. The overall length of hospital stay was slightly higher than that of the control group [MD=1.46, 95% CI (-3.16, 6.08), P=0.54], but the difference was not statistically significant; the overall ICU stay was slightly higher than that of the control group [MD=0.11, 95% CI (-1.32, 1.54), P=0.88], but the difference was not statistically significant; the incidence of adverse effects in the two groups incidence was comparable [RR=1.09, 95% CI (0.89, 1.34), P=0.40]. CONCLUSIONS The use of IVIG did not reduce mortality, length of hospital stay, and ICU stay in patients with severe or critical COVID-19, and therefore the clinical use of IVIG is not recommended for the treatment of patients with severe or critical COVID-19. |
| Key words: Intravenous human immunoglobulin severe critical COVID-19 Meta-analysis |
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