皮质类固醇激素治疗前庭神经炎疗效的Meta分析

Meta Analysis of the Effect of Corticosteroids in the Treatment of Vestibular Neuritis

柳鑫;邢巍巍;

1:锦州医科大学附属第一医院耳鼻咽喉头颈外科

摘要
目的 系统评价皮质类固醇激素治疗前庭神经炎(vestibular neuritis, VN)的临床疗效,为临床使用皮质类固醇激素治疗VN提供参考。方法 通过检索中国知网、万方、维普、Web of science、EMBASE、Cochrane library、Pubmed数据库,根据纳入和排除标准筛选关于皮质类固醇激素治疗前庭神经炎的相关文献,所有研究对象分为激素组和对照组,结局评价指标为冷热试验半规管轻瘫(canal paresis, CP)值、眩晕残障程度评定量表(dizziness handicap inventory, DHI)评分以及住院时间,采用严格文献质量方法学标准进行评价,应用RevMan5.3软件进行Meta分析。结果 最终纳入9篇文献,共426例患者,其中激素组189例,对照组237例。Meta分析结果显示:治疗后1、6、12个月,两组患者CP值风险比(relative risk, RR)值分别为1.80、95%Cl(0.70,4.63)、1.01、95%Cl(0.74,1.39)和1.54、95%Cl(0.88,2.69),差异无统计学意义(P>0.05);治疗后1个月,两组患者DHI评分差异无统计学意义[MD=3.36,95%Cl(-4.93,11.65),Z=0.80,P>0.05],治疗后6个月DHI评分的差异有统计学意义[MD=-2.41,95%Cl(-4.29,-0.53),Z=2.52,P=<0.05];两组患者住院时间比较差异有统计学意义[MD=-0.92,95%Cl(-1.37,-0.47),Z=4.04,P<0.000 1]。结论 皮质类固醇激素治疗VN能有效缩短住院时间,但在临床症状及前庭功能恢复方面并不优于对照组。
关键词
皮质类固醇激素;前庭神经炎;疗效;Meta分析
基金项目(Foundation):
作者
柳鑫;邢巍巍;
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