硫酸镁治疗成人哮喘急性发作的系统评价

doi:10.5246/jcps.2016.08.070

中国药学(英文版) ›› 2016, Vol. 25 ›› Issue (8): 621-631.DOI: 10.5246/jcps.2016.08.070

硫酸镁治疗成人哮喘急性发作的系统评价

马卓, 崔向丽, 刘丽宏^*

首都医科大学附属北京朝阳医院药事部, 北京 100020

收稿日期:2016-03-13 修回日期:2016-05-03 出版日期:2016-09-01 发布日期:2016-05-12
通讯作者: Tel.: +86-010-85231077, +86-010-85231788, E-mail: mazhuo2013@163.com, hongllh@126.com

A systematic review of magnesium sulfate for acute asthma in adults

Zhuo Ma, Xiangli Cui, Lihong Liu^*

Pharmacy Department of Beijing Chao Yang Hospital, Capital Medical University, Beijing 100020, China

Received:2016-03-13 Revised:2016-05-03 Online:2016-09-01 Published:2016-05-12
Contact: Tel.: +86-010-85231077, +86-010-85231788, E-mail: mazhuo2013@163.com, hongllh@126.com

摘要/Abstract

摘要：

系统定量评价静脉注射和雾化吸入硫酸镁治疗成人哮喘急性发作的有效性和安全性, 为临床决策提供证据。系统检索Pubmed, Embase, the Web of Sciences, Cochrane图书馆、CNKI及万方数据库, 检索时限至2016年1月。全面收集静脉注射和雾化吸入硫酸镁对比安慰剂治疗成人哮喘急性发作的随机对照研究(RCTs), 主要结局指标为住院率, 次要结局指标包括肺功能、临床症状评分、生命体征、不良反应、对符合纳入标准的文献进行质量评价, 并运用RevMan 5.2 软件进行meta分析。共纳入24个RCTs, 2931例患者。静脉注射和雾化吸入硫酸镁都未显著降低成人急性哮喘患者的住院率(RR 0.91, 95% CI 0.80 to 1.03, P = 0.14; RR 0.78, 95% CI 0.56 to 1.08, P = 0.14)。可改善患者的肺功能(SMD 0.23, 95% CI 0.03 to 0.43, P = 0.02; SMD 0.37, 95% CI 0.11 to 0.64, P = 0.006); 但踢除小样本研究作敏感性分析显示静脉注射和和雾化吸入都未能改善患者肺功能(SMD 0.05, 95% CI -0.05 to 0.15, P = 0.35; SMD 0.05, 95% CI -0.16 to 0.25, P = 0.64)。静脉注射和雾化吸入硫酸镁与安慰剂比较, 患者临床症状评分和生命体征(心率、收缩压、呼吸频率)无明显改变(P>0.05)。无一篇文献报道严重不良反应的发生。因此, 静脉注射和雾化吸入硫酸镁对成人哮喘急性发作未显示有利影响。考虑到硫酸镁发生严重不良反应的低风险性和易获得性, 可考虑在威胁生命的哮喘急性发作患者中使用静脉注射或雾化吸入硫酸镁治疗。

关键词: 硫酸镁, 成人哮喘, 系统评价

Abstract:

In order to provide evidence for making clinical decision, the role of intravenous and nebulized MgSO₄ in treatment of adult’s acute asthma was systematically estimated in the present study. Pubmed, Embase, Web of Sciences, the Cochrane Library and two Chinese literature databases (CNKI, WanFang) were systematically searched up to January 2016. Randomized controlled trails (RCTs) that compared the clinical outcomes of MgSO₄ groups and placebo groups were included. The primary outcome was hospital admission. Secondary outcomes included pulmonary function, symptom scores, vital signs and adverse events. The methodological quality of the included studies was evaluated, and the forest plots with meta-analysis were drawn by RevMan 5.2. A total of 24 RCTs derived from 2931 patients were included. Both intravenous MgSO₄ and nebulized MgSO₄treatmentshad no effect upon hospital admission (RR 0.91, 95% CI 0.80 to 1.03, P = 0.14; RR 0.78, 95% CI 0.56 to 1.08, P = 0.14). Both intravenous MgSO₄ and nebulized MgSO₄treatmentswere associated with significant evidence upon respiratory function (SMD 0.23, 95% CI 0.03 to 0.43, P = 0.02; SMD 0.37, 95% CI 0.11 to 0.64, P = 0.006), but sensitivity analyses showed that outcomes were changed by omitting studies of less than 100 individuals (SMD 0.05, 95% CI -0.05 to 0.15, P = 0.35; SMD 0.05, 95% CI -0.16 to 0.25, P = 0.64). There were no statistically significant differences in clinical symptom scores and vital signs (heart or pulse rate; systolic blood pressure; respiratory rate) in either form of MgSO₄ compared with placebo groups (P>0.05). There were no serious adverse events reported in any literature. Overall, there was no role for intravenous and nebulized MgSO₄ in the management of acute asthma in adults. Considering the low risk of serious adverse effects and easy availability, it seemed reasonable to use intravenous or nebulized MgSO₄ treatment in adults with life threatening asthma in whom any potential benefit would justify the risks of treatment.

Key words: Magnesium sulphate, Adult asthma, Systematic review

中图分类号:

R954

Supporting:

马卓, 崔向丽, 刘丽宏. 硫酸镁治疗成人哮喘急性发作的系统评价[J]. 中国药学(英文版), 2016, 25(8): 621-631.

Zhuo Ma, Xiangli Cui, Lihong Liu. A systematic review of magnesium sulfate for acute asthma in adults[J]. Journal of Chinese Pharmaceutical Sciences, 2016, 25(8): 621-631.

参考文献

[1] Subbarao, P.; Mandhane, P.J.; Sears, M.R. CMAJ. 2009, 181, E181-190.
[2] Guerrera, M.P.; Volpe, S.L.; Mao, J.J. Am. Fam. Physician. 2009, 80, 157-162.
[3] Spivey, W.H.; Skobeloff, E.M.; Levin, R.M. Ann. Emerg. Med. 1990, 19, 1107-1112.
[4] Gourgoulianis, K.I.; Chatziparasidis, G.; Chatziefthimiou, A.; Molyvdas, P.A. J. Aerosol. Med. 2001, 14, 301-307.
[5] Classen, H.G.; Jacob, R.; Schimatschek, H. Magnes. Bull. 1987, 9, 80-87.
[6] Higgins, J.; Thompson, S.; Deeks, G.; Altman, D. BMJ. 2003, 327, 557-560.
[7] Goodacre, S.; Cohen, J.; Bradburn, M.; Gray, A.; Benger, J.; Coats, T.; 3Mg Research Team. Lancet Respir. Med. 2013, 1293-300.
[8] Skobeloff, E.M.; Spivey, W.H.; McNamara, R.M.; Greenspon, L. JAMA. 1989, 262, 1210-1213.
[9] Green, S.M.; Rothrock, S.G. Ann. Emerg. Med. 1992, 21, 260-265.
[10] Tiffany, B.R.; Berk, W.A.; Todd, I.K.; White, S.R. Chest. 1993, 104, 831-834.
[11] Matusiewicz, S.P.; Cusack, S.; Greening, A.P.; Crompton, G.K. European Respiratory J. 1994, 7, 14s.
[12] Bloch, H.; Silverman, R.; Mancherje, N.; Grant, S.; Jagminas, L.; Scharf, S.M. Chest. 1995, 107, 1576-1581.
[13] Boonyavorakul, C.; Thakkinstian, A.; Charoenpan, P. Respirology. 2000, 5, 221-225.
[14] Bilaceroglu, S.; Akpinar, M.; Tiras, A.; Celikten, E.; Kalenci, D. American Thoracic Society 97th International Conference. 2011, May 18-23, San Francisco.
[15] Bijani, K.; Moghadamnia, A.A.; Islami Khalili, E. Acta Med. Iranica. 2001, 39, 219-221.
[16] Porter, R.S.; Nester Braitman, L.E.; Geary, U.; Dalsey, W.C. Eur. J. Emerg. Med. 2001, 8, 9-15.
[17] Silverman, R.A.; Osborn, H.; Runge, J.; Gallagher, E.J.; Chiang, W.; Feldman, J.; Gaeta, T.; Freeman, K.; Levin, B.; Mancherje, N.; Scharf, S.; Acute Asthma/MagnesiumStudy Group. Chest. 2002, 122, 489-497.
[18] Bradshaw, T.A.; Matusiewicz, S.P.; Crompton, G.K.; Alastair Innes, J.; Greening, A.P. Respir. Med. 2008, 102, 143-149.
[19] Singh, A.K.; Gaur, S.; Kumar, R. Iran J. Allergy Asthma Immunol. 2008, 7, 221-229.
[20] Nannini, L.J.Jr.; Pendino, J.C.; Corna, R.A.; Mannarino, S.; Quispe, R. Am. J. Med. 2000, 108, 193-197.
[21] Bessmertny, O.; DiGregorio, R.V.; Cohen, H.; Becker, E.; Looney, D.; Golden, J.; Kohl, L.; Johnson, T. Ann. Emerg. Med. 2002, 39, 585-591.
[22] Xu, C.Q.; Yang, J.; Meng, X.K. Chin. J. Clin. Pharmacol. Ther. 2002, 7, 446-448.
[23] Xiang, S.P.; Li, Y.Q.; Zeng, Z.Y.; Li, G.C.; Liang, R.Y.; Li, J.G. Chin. J. Intern. Med. 2002, 41, 54-55.
[24] Hughes, R.; Goldkorn, A.; Masoli, M.; Weatherall, M.; Burgess, C.; Beasley, R. Lancet. 2003, 361, 2114-2117.
[25] Kokturk, N.; Turktas, H.; Kara, P.; Mullaoglu, S.; Yilmaz, F.; Karamercan, A. Pulm Pharmacol. Ther. 2005, 18, 416-421.
[26] Zhu, F.Y.; Li, L.J.; Yu, W.J.; Zhao, X.F. Shanxi Med. J. 2005, 34, 50-51.
[27] Aggarwal, P.; Sharad, S.; Handa, R.; Dwiwedi, S.N.; Irshad, M. Emerg. Med. J. 2006, 23, 358-362.
[28] Drobina, B.J.; Kostic, M.A.; Roos, J.A. Academic Emerg. Med. 2006, 13, 26.
[29] Gallegos-Solorzano, M.C.; Perez-Padilla, R.; Hernandez-Zenteno, R.J. Pulm Pharmacol. Ther. 2010, 23, 432-437.
[30] Badawy, M.S.H.; Hassanin, I.M.A. Egypt. J. Chest Diseases Tuberculosis. 2014, 63, 285-289.
[31] Rowe, B.H.; Bretzlaff, J.A.; Bourdon, C.; Bota, G.W.; Camargo, C.A.Jr. Cochrane Database Syst. Rev. 2000, 2, CD001490.
[32] Mohammed, S.; Goodacre, S. Emerg. Med. J. 2007, 24, 823-830.
[33] Powell, C.; Dwan, K.; Milan, S.J.; Beasley, R.; Hughes, R.; Knopp-Sihota, J.A.; Rowe, B.H. Cocharane Database Syst. Rev. 2012, 12, 12:CD003898.
[34] Shan, Z.; Rong, Y.; Yang, W.; Wang, D.; Yao, P.; Xie, J.; Liu, L. Respir. Med. 2013, 107, 321-330.

硫酸镁治疗成人哮喘急性发作的系统评价

A systematic review of magnesium sulfate for acute asthma in adults

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 10

编辑推荐

Metrics

本文评价

[1]	吴崇昊, 黄攀杰, 杨春琦, 高川, 曾鸣. 恶性胸膜间皮瘤免疫检查点抑制剂疗效及安全性meta分析[J]. 中国药学(英文版), 2023, 32(4): 291-301.
[2]	苏俐玫, 毛溪悦, 阳丽梅. 肺癌患者静脉血栓栓塞预防的疗效与安全性的meta分析[J]. 中国药学(英文版), 2023, 32(10): 852-860.
[3]	肖锐锐, 徐秀琴, 孙磊, 方晓磊, 肖鹏. 降心率药物伊伐布雷定安全性的系统评价[J]. 中国药学(英文版), 2017, 26(5): 379-389.
[4]	杨会霞, 陈恳, 梁舒瑶, 翟所迪, 易湛苗. 合用CPY450酶抑制剂对伏立康唑安全性和药代动力学的影响的系统评价[J]. 中国药学(英文版), 2017, 26(3): 202-211.
[5]	韩茹, 安雅晶, 赵荣生. α-酮酸对慢性肾脏病患者的附加作用: 一项随机对照试验的系统评价和meta分析[J]. 中国药学(英文版), 2017, 26(1): 63-75.
[6]	董悦, 赵明, 胡欣. 替拉万星疗效及安全性的系统评价和Meta分析[J]. 中国药学(英文版), 2016, 25(3): 215-223.
[7]	郭子寒, 焦园园, 易占苗, 李然, 张艳华. 癌症患者使用依维莫司会增加高血糖风险的系统评价[J]. 中国药学(英文版), 2015, 24(5): 326-335.
[8]	韩晟, 王宽, 濮润, 史录文^*. 软聚硅酮泡沫吸收敷料治疗压疮的药物经济学研究[J]. , 2013, 22(5): 456-460.
[9]	杨敏, 卢静, 蒋学华^*. 透明质酸治疗烧烫伤的系统评价[J]. , 2013, 22(3): 277-281.
[10]	董志, 曾凡新, 周岐新, 傅洁民, 薛春生. 果糖二磷酸钠镁对大鼠脑缺血—再灌注损伤的保护作用[J]. , 2002, 11(1): 42-45.