两种剂量甲泼尼龙治疗急性脊髓炎疗效与安全性比较的系统评价

雷洁昕; 陈鹏; 陈富超; 高凌

doi:10.14009/j.issn.1672-2124.2020.03.017

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两种剂量甲泼尼龙治疗急性脊髓炎疗效与安全性比较的系统评价

用药评价 | 更新时间：2022-10-08

- 两种剂量甲泼尼龙治疗急性脊髓炎疗效与安全性比较的系统评价
- Systematical Review of Comparison of Efficacy and Safety of Two Different Doses of Methylprednisolone in the Treatment of Acute Myelitis
- 中国医院用药评价与分析 2020年20卷第3期页码：324-327
- 作者机构：
  
  1. 武汉大学人民医院内分泌科
  2. 武汉大学人民医院药学部
  3. 湖北医药学院附属东风医院药学部
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2020.03.017
  中图分类号： R969;R744.3
- 纸质出版日期：2020，
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[1]雷洁昕,陈鹏,陈富超,高凌.两种剂量甲泼尼龙治疗急性脊髓炎疗效与安全性比较的系统评价[J].中国医院用药评价与分析,2020,20(03):324-327+332.

LEI Jiexin, CHEN Peng, CHEN Fuchao, et al. Systematical Review of Comparison of Efficacy and Safety of Two Different Doses of Methylprednisolone in the Treatment of Acute Myelitis[J]. 2020,20(3):324-327.
[1]雷洁昕,陈鹏,陈富超,高凌.两种剂量甲泼尼龙治疗急性脊髓炎疗效与安全性比较的系统评价[J].中国医院用药评价与分析,2020,20(03):324-327+332. DOI： 10.14009/j.issn.1672-2124.2020.03.017.

LEI Jiexin, CHEN Peng, CHEN Fuchao, et al. Systematical Review of Comparison of Efficacy and Safety of Two Different Doses of Methylprednisolone in the Treatment of Acute Myelitis[J]. 2020,20(3):324-327. DOI： 10.14009/j.issn.1672-2124.2020.03.017.

摘要

目的:基于荟萃分析（Meta分析）方法

比较两种剂量甲泼尼龙治疗急性脊髓炎的有效性与安全性。方法:计算机检索Pub Med、EMBase、the Cochrane Library、中国知网及维普数据库等数据库

收集两种剂量甲泼尼龙治疗急性脊髓炎的临床随机对照试验（大剂量组患者使用甲泼尼龙1次1 000 mg

1日1次;小剂量组患者使用甲泼尼龙1次500 mg

1日1次）

提取数据并进行方法学质量评价后

采用Rev Man 5. 3软件进行Meta分析。结果:共纳入8篇文献

涉及798例患者。Meta分析结果显示

治疗后

大剂量组患者的美国脊髓损伤协会评分（运动功能评分:WMD=-4. 97

95%CI=-5. 84～-4. 10

P<0. 000 01;痛觉评分:WMD=-5. 24

95%CI=-6. 03～-4. 46

P<0. 000 01;触觉评分:WMD=-6. 92

95%CI=-7. 85～-5. 99

P<0. 000 01）明显高于小剂量组

差异有统计学意义;大剂量组患者的排尿恢复时间（WMD=-6. 92

95%CI=3. 24～7. 52

P<0. 000 01）、自行下地行走时间（WMD=5. 46

95%CI=3. 73～7. 18

P<0. 000 01）和肌力改善2级的时间（WMD=-0. 02

95%CI=1. 46～3. 90

P<0. 000 01）明显短于小剂量组

差异均有统计学意义;大剂量组患者的临床总有效率明显高于小剂量组

差异有统计学意义（OR=2. 68

95%CI=1. 95～2. 78

P<0. 000 1）。仅1篇文献报告治疗期间两组患者均未出现严重不良反应及并发症。结论:与小剂量（1次500 mg

1日1次）甲泼尼龙相比

大剂量（1次1 000 mg

1日1次）甲泼尼龙在促进急性脊髓炎患者神经功能恢复、提高治疗效果和改善预后等方面更具优势

但仍需高质量的研究证据加以验证和支撑。

Abstract

OBJECTIVE: To compare the efficacy and safety of two different doses of methylprednisolone in the treatment of acute myelitis based on Meta analysis. METHODS: Pub Med

EMBase

the Cochrane Library

CNKI and VIP database were retrieved to collect the randomized controlled trials of two different doses of methylprednisolone in the treatment of acute myelitis（ the high-dose group received methylprednisolone 1 000 mg for once a day

while the low-dose group was treated with methylprednisolone 500 mg for once a day）. After data extraction and methodological quality evaluation

Meta analysis was performed by using Rev Man 5. 3 software. RESULTS: Totally 8 literature were collected

including 798 patients. After treatment

the American Spinal Cord Injury Association scores（ motor function score: WMD =-4. 97

95%CI =-5. 84--4. 10

P < 0. 000 01; pain score: WMD =-5. 24

95% CI =-6. 03--4. 46

P <0. 000 01; tactile score: WMD =-6. 92

95% CI =-7. 85--5. 99

P < 0. 000 01） of the high-dose group were significantly higher than those the low-dose group

the differences were statistically significant. The urination recovery time（ WMD =-6. 92

95% CI = 3. 24-7. 52

P < 0. 000 01）

self-walking time（ WMD = 5. 46

95% CI = 3. 73-7. 18

P <0. 000 01）

time to improve muscle strength level 2（ WMD =-0. 02

95%CI = 1. 46-3. 90

P < 0. 000 01） of the highdose group were significantly shorter than those of the low-dose group

the differences were statistically significant. The total effective rate of the high-dose group was significantly higher than that of the low-dose group

and the difference was statistically significant（ OR = 2. 68

95%CI = 1. 95-2. 78

P<0. 000 1）. Only one literature reported that there were no severe adverse drug reactions and complications in two groups during the treatment. CONCLUSIONS: Compared with low-dose methylprednisolone（ 500 mg for once a day）

high-dose methylprednisolone（ 1 000 mg for once a day）has more advantages in promoting neurological recovery

improving treatment effect and prognosis in patients with acute myelitis

but high-quality research evidence is still needed to verify and support it.

关键词

甲泼尼龙急性脊髓炎剂量Meta分析

Keywords

MethylprednisoloneAcute myelitisDoseMeta-analysis

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