吸入糖皮质激素对哮喘儿童身高影响的 Meta分析

目的：系统评价吸入糖皮质激素（ICS）治疗对哮喘儿童身高的影响。方法全面检索万方、知网、CENTRAL、EM‐BASE、MEDLINE、CINAHL等数据库中1979年至2014年10月ICS治疗对哮喘儿童身高增长影响的相关文献，语种限中文和英文。纳入原始研究、质量评价并提取资料，剔除不符合研究标准的文献，对所纳入的研究数据采用RevMan5．2软件进行统计学分析。结果 M eta分析结果显示ICS治疗6～8月哮喘儿童身高增长平均减少0．77 cm ，治疗1年哮喘儿童身高增长平均减少0．55 cm ，均与对照组比较差异有统计学意义（M D＝－0．77、－0．55，P＜0．01）；ICS治疗2年哮喘儿童身高增长平均减少0．30 cm ，但与对照组比较差异无统计学意义（MD＝－0．30，P＞0．05）。结论 ICS治疗对哮喘儿童身高增长有暂时抑制作用，其抑制作用在半年内较明显，随时间推移抑制作用减少。

Effects of inhaled corticosteroids in children with persistent asthma on growth:a Meta-analysis

Objective To assess the effects of inhaled corticosteroids on growth velocity in children with asthma .Methods We searched the Cochrane Airways Group Specialised Register of trials (CAGR) ,which was derived from systematic searches of bibliographic databases including CENTRAL ,MEDLINE ,EMBASE ,CINAHL ,AMED and PsycINFO .We also searched Wan Fang Chinese periodical Database and VIP Chinese periodical Database from the establishment of the database to October 2014 .Articles which were parallel‐group randomised controlled trials comparing daily used of ICS ,delivered by any type of inhalation device ,ver‐sus placebo or non‐steroidal drugs in children up to 18 years of age with persistent asthma are selected .The data analysis was used by RevMan 5 .2 software .Results A total of 18 randomized control trials were included .Meta analysis showed that inhaled cortico‐steroids for 6-8 months ,1 year significantly slowing down growth velocity in children with asthma (MD= -0 .77 ,-0 .55 ,respec‐tively ,P<0 .01) .Inhaled corticosteroids for 2 years had no significant inhibition on growth velocity in children with asthma (MD=-0 .30 ,P>0 .05) .Conclusion This systematic review showed that ICS therapy had temporarily inhibition on growth velocity in children with asthma ,the peak inhibition happen within half a year ,its inhibitory effect decrease with time .