Adjunctive corticosteroids for the treatment of Pneumocystis jiroveci pneumonia in patients with HIV: A meta‑analysis
Adjunctive corticosteroids for the treatment of Pneumocystis jiroveci pneumonia in patients with HIV: A meta‑analysis
复制标题
辅助皮质类固醇治疗 HIV 患者的耶氏肺孢子虫肺炎：一项荟萃分析
DOI：
10.3892/etm.2015.2929
复制
发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Jiegang Huang
中科院分区：
文献类型：
--
作者：
Li Wang;Hao Liang;Li Ye;Junjun Jiang;Bingyu Liang;Jiegang Huang
本研究旨在评估辅助性糖皮质激素治疗对人类免疫缺陷病毒（HIV）感染者的耶氏肺孢子菌肺炎的疗效。使用包括PubMed、EMbase和Ovid在内的多个网站，以“糖皮质激素、糖皮质类固醇、皮质醇、皮质酮、HIV/获得性免疫缺陷综合征、耶氏肺孢子菌肺炎和PCP”为关键词，对2014年3月之前发表的相关随机对照试验（RCT）进行了文献检索。本研究对所有探讨在HIV感染者中使用辅助性糖皮质激素治疗耶氏肺孢子菌肺炎的RCT进行了评估。使用Stata 11.0软件在进行一致性和潜在偏倚检验后计算相对危险度（RR）和95%置信区间（CI）。在本次荟萃分析中，对6项共涉及548例患者的RCT进行了评估。实验组（n = 270）的死亡率为15.2%（n = 41），而对照组（n = 278）为27.7%（n = 77）。本次荟萃分析表明，辅助性糖皮质激素治疗后的RR和95%CI分别为0.55和0.35 - 0.85（P < 0.05）。这一结果表明，与对照组相比，实验组患者的死亡风险降低了0.55倍。因此，本次荟萃分析的结果表明，在HIV感染者中使用辅助性糖皮质激素治疗耶氏肺孢子菌肺炎可能会降低患者在疾病早期的死亡率。
The present study aimed to evaluate the effects of adjunctive corticosteroid treatment on Pneumocystis jiroveci pneumonia in patients with human immunodeficiency virus (HIV). A literature search of relevant randomized controlled trials (RCTs) published prior to March 2014 was performed using a number of websites, including PubMed, EMbase and Ovid, using the following keywords: Corticosteroids, glucocorticoide, cortisol, corticosterone, HIV/acquired immunodeficiency syndrome, P. jiroveci pneumonia, and PCP. All RCTs investigating the use of adjunctive corticosteroids for the treatment of P. jiroveci pneumonia in patients with HIV were evaluated in the present study. Stata 11.0 software was used to calculate the relative risk (RR) and 95% confidence interval (CI) following tests for consistency and potential biases. Six RCTs investigating a total of 548 patients were evaluated in the present meta-analysis. The experimental groups (n=270) demonstrated a mortality rate of 15.2% (n=41); as compared with 27.7% (n=77) in the control groups (n=278). The present meta-analysis demonstrated that the RR and 95% CI were 0.55 and 0.35-0.85 (P<0.05), respectively, following treatment with adjunctive corticosteroids. This result indicated that patients in the experimental group had a 0.55 times reduced risk of mortality compared with the control group. Therefore, the results of the present meta-analysis demonstrated that the administration of adjunctive corticosteroids for the treatment of P. jiroveci pneumonia in patients with HIV may reduce the mortality rate of patients in the early phase of the disease.