Intravenous Immunoglobulin Therapy for Acute Myocarditis in Children and Adults
Intravenous Immunoglobulin Therapy for Acute Myocarditis in Children and Adults
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儿童和成人急性心肌炎的静脉注射免疫球蛋白治疗
DOI：
10.1536/ihj.18-299
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发表时间：
2019-03-01
影响因子：
1.5
通讯作者：
Shuai, Xinxin
中科院分区：
文献类型：
--
作者：
Huang, Xin;Sun, Yufei;Shuai, Xinxin
静脉注射免疫球蛋白（IVIG）治疗急性心肌炎的疗效仍有争议。本研究的目的是进行一项荟萃分析，以评估IVIG对急性心肌炎儿童和成人的疗效。我们检索了PubMed、Scopus、Embase、Medline、Cochrane Library、谷歌Scholar和clinicaltrials .gov网站。符合条件的研究是急性心肌炎患者接受IVIG治疗的临床试验。使用合并优势比（or）和95%置信区间（ci）来估计结果。13项研究共1534例纳入我们的荟萃分析。综合结果显示，IVIG治疗显著降低急性心肌炎患者的住院死亡率（OR: 0.44, 95% CI 0.17 ~ 0.71, P < 0.001），改善左心室射血分数（LVEF） （OR: 1.73, 95% CI 1.34 ~ 2.13, P < 0.001）。此外，急性暴发性心肌炎（AFM）患者在IVIG组的生存率显著提高（OR: 2.80, 95% CI 1.16 ~ 6.77, P = 0.022）。IVIG治疗不仅可以降低急性心肌炎患者的住院死亡率和提高左心室功能的恢复，而且可以提高AFM患者的生存率。本研究为体外免疫球蛋白治疗急性心肌炎提供了一些支持证据。
The efficacy of intravenous immunoglobulin (IVIG) in the treatment of acute myocarditis remains controversial. The aim of this study was to conduct a meta-analysis to assess the efficacy of IVIG in children and adults with acute myocarditis.We searched PubMed, Scopus, Embase, Medline, the Cochrane Library, Google Scholar, and the Clinical-Trials.gov website. Eligible studies were clinical trials of patients with acute myocarditis who received IVIG therapy. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the outcomes.Thirteen studies with 1534 cases were incorporated into our meta-analysis. Pooled results showed that IVIG therapy significantly reduced in-hospital mortality (OR: 0.44, 95% CI 0.17 to 0.71, P < 0.001) and improved the left ventricular ejection fraction (LVEF) (OR: 1.73, 95% CI 1.34 to 2.13, P < 0.001) in acute myocarditis patients. Furthermore, patients with acute fulminant myocarditis (AFM) exhibited a significantly higher survival rate (OR: 2.80, 95% CI 1.16 to 6.77, P = 0.022) in the IVIG group.IVIG therapy can not only result in lower in-hospital mortality and superior recovery of left ventricular function in patients with acute myocarditis, but also increase the survival rate of AFM patients. The present study provides some supportive evidence for IVIG therapy in acute myocarditis patients.