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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Efficacy of beta2-agonists in bronchiolitis: a reappraisal and meta-analysis.
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Efficacy of beta2-agonists in bronchiolitis: a reappraisal and meta-analysis.

机译：β2-激动剂在毛细支气管炎中的功效：重新评估和荟萃分析。

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OBJECTIVE: To evaluate the efficacy of beta2-agonists in bronchiolitis. DESIGN: Critical review and meta-analysis of randomized controlled trials of inhaled beta2-agonists. RESULTS: Three inpatient and five outpatient studies were identified. Inpatient studies (82 patients) were characterized by wide variability in therapeutic regimens and measurement of outcomes. Several problems were identified in the selection and specification of patients, such as failure to assess the prestudy duration of illness or to exclude patients already taking bronchodilators. Meta-analysis was not possible for inpatient trials due to the great variability in study outcomes, timing of outcome assessment, and drug regimens. Results of inpatient trials were contradictory: one found significant reductions in the clinical score and a shorter hospital stay with treatment, whereas two others found only significant oxygen desaturations. Outpatient studies (251 patients) examined immediate changes in physiologic measures and clinical scores after two treatments, but have not examined the effects of the longer-term regimen customarily used by clinicians. Meta-analysis revealed that short-term beta2-agonist therapy had no impact on the hospitalization rate or respiratory rate, and had a statistically significant but clinically insignificant impact on oxygen saturation and heart rate. The diversity of scoring systems precluded pooling of clinical score data. CONCLUSIONS: Despite eight clinical trials, conclusive evidence for the efficacy of beta2-agonist therapy for bronchiolitis remains unavailable. Well-designed inpatient trials are needed. Meta-analysis of outpatient studies does not support the use of beta2-agonist therapy for bronchiolitis, but investigators have not studied the outcomes and the long-term outpatient regimen customarily used by clinicians.
机译：目的：评估β2-激动剂在毛细支气管炎中的疗效。设计：吸入性β2受体激动剂的随机对照试验的严格回顾和荟萃分析。结果：确定了三项住院和五项门诊研究。住院研究（82例患者）的特点是治疗方案和结局指标差异很大。在选择患者和确定患者规格时发现了一些问题，例如未能评估疾病的预研究时间或无法排除已经服用支气管扩张剂的患者。由于研究结果，结果评估时机和药物治疗方案的差异很大，因此无法进行住院试验的荟萃分析。住院试验的结果相互矛盾：一项发现临床评分显着降低，而住院治疗时间缩短，而另两项发现仅氧饱和度降低。门诊研究（251例患者）检查了两种治疗后生理指标和临床评分的即时变化，但未检查临床医生习惯使用的长期治疗方案的效果。荟萃分析显示，短期β2-激动剂治疗对住院率或呼吸频率没有影响，对氧饱和度和心率有统计学意义，但在临床上无统计学意义。评分系统的多样性使得无法合并临床评分数据。结论：尽管进行了八项临床试验，但尚无关于β2-激动剂治疗细支气管炎疗效的确凿证据。需要精心设计的住院试验。对门诊研究的荟萃分析不支持将β2-激动剂用于细支气管炎，但研究人员尚未研究临床医生习惯使用的结局和长期门诊治疗方案。

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