环丙沙星对小儿骨关节不良影响的评价

目的 评价环丙沙星对小儿骨关节的不良影响。方法 计算机检索MEDLINE（1985～2006．3）、Cochrane图书馆（2006年1期）、EMBASE（1985～2006-3）、中国生物医学文献数据库（1990～2006年）、中国循证医学中心随机对照试验资料库，收集环丙沙星对儿童安全性的随机对照试验，逐篇评价纳入研究的质量，并采用RevMan4．2进行Meta分析。 结果 共纳入7篇随机对照研究，质量等级均为B或C级。Meta分析结果显示，环丙沙星组与对照组相比，关节疼痛差异无统计学意义[RR总0．98，95％CI（0、65，1．48）]。未发现有骨关节及软骨的X片、超声波或MRI的改变。结论 尚无确切证据显示应用环丙沙星对小儿骨关节的生长发育造成影响，也无证据表明造成负重关节的软骨损害，但仍有必要进一步了解环丙沙星在不同剂量、不同年龄组、不同疗程下对小儿骨关节及软骨的长期影响。

Assess the Potential of Ciprofloxacin to Induce Arthropathy in Children: A Systematic Review

Objective To assess the potential of ciprofloxacin to induce arthropathy in children and provide evidence for clinical practice. Methods We searched MEDLINE(1985- March 2006), The Cochrane Library (Issue 1,2006), EMBASE(1985 to March 2006) and CBMdisk(1990 to March 2006) for randomized controlled trials (RCTs) involving the safety of ciprofloxacin in pediatrics. We assessed the methodological quality of the studies identified. RevMan 4.2 was used for meta-analysis. Results Seven RCTs met the inclusion criteria. Compared with the control group, the combined rate of arthralgia did not increase compared to ciprofloxacin. The relative risk was 0.98, 95% confidence interval 0.65 to 1.48. No studies reported joint pathology and cartilage lesions on radiographic imaging, ultrasound or magnetic resonance imaging in the pediatric population. Conclusion Based on the results of the review and the meta-analysis, there is no evidence that using ciprofloxacin in the pediatric population is associated with clinical arthropathy. Further well-designed clinical studies should be performed to assess the long-term consequences of the use of ciprofloxacin in children.