目的探讨免疫疗法治疗脑卒中的临床疗效。方法检索中国知网、维普、万方、CBM、Cochrane Library、Embase、PubMed和Web of Science数据库2000—2022年关于免疫疗法治疗脑卒中的随机对照试验,通过RevMan5.3、Stata14进行质量评估和网状M...目的探讨免疫疗法治疗脑卒中的临床疗效。方法检索中国知网、维普、万方、CBM、Cochrane Library、Embase、PubMed和Web of Science数据库2000—2022年关于免疫疗法治疗脑卒中的随机对照试验,通过RevMan5.3、Stata14进行质量评估和网状Meta分析。结果最终纳入11篇文献,共计2742例患者。Meta分析结果显示,与安慰剂相比,免疫药物干预对第90 d mRS评分(P=0.45)及Barthel指数(P=0.33)均无明显影响。网状Meta分析结果显示,与安慰剂相比,GSK249320(OR=1.33,95%CI 0.48~3.67)、Abciximab(OR=1.20,95%CI 0.69~2.07)、Cyclosporine(OR=1.07,95%CI 0.39~2.95)的mRS评分0~1分的患者比例及IL-1Ra(OR=1.22,95%CI 0.75~1.96)、Abciximab(OR=2.75,95%CI 0.36~20.96)的Barthel指数评分有升高趋势,但差异均无统计学意义(P>0.05)。mRS评分累计概率排名曲线下面积(SUCRA)排序为GSK249320>Abciximab>Cyclosporine>Placebo>IL-1Ra>Natalizumab>Enlimomab;Barthel指数SUCRA排序为IL-1Ra>Abciximab>Placebo>Natalizumab。结论与安慰剂相比,免疫疗法治疗脑卒中并未表现出更好的疗效,其原因可能与目前对卒中免疫的时空动态性、个体化特征了解尚不足,缺乏系统、全面的免疫治疗方案有关。展开更多
目的:通过总结1例度普利尤单抗联合变应原特异性免疫疗法治疗青春期难治性支气管哮喘的临床资料,提高临床医生对青春期难治性哮喘的认识。方法:回顾性分析我院收治的1例青春期难治性支气管哮喘患儿的临床资料,并进行文献复习。结果:该...目的:通过总结1例度普利尤单抗联合变应原特异性免疫疗法治疗青春期难治性支气管哮喘的临床资料,提高临床医生对青春期难治性哮喘的认识。方法:回顾性分析我院收治的1例青春期难治性支气管哮喘患儿的临床资料,并进行文献复习。结果:该患儿出院后规律雾化,加用度普利尤单抗联合变应原特异性免疫疗法治疗,支气管哮喘及特应性皮炎得到了良好控制,ACT评分、SCOARD评分、PAQLQ评分及肺功能得到明显的改善。结论:1) 度普利尤单抗联合变应原特异性免疫疗法对青春期难治性支气管哮喘疗效显著,同时可以缓解特应性皮炎的临床症状。2) 青春期支气管哮喘患儿的综合管理至关重要,合并其他2型炎症会增加其治疗难度。3) 临床医生在常规治疗的过程中需注重对患儿的健康教育和情绪管理,提高青春期支气管哮喘过渡管理水平,促进全生命周期的呼吸健康管理Objective: To improve the understanding of adolescent refractory asthma by summarizing the clinical data of a case of Dupilumab combined with allergen specific immunotherapy for adolescent refractory bronchial asthma. Methods: The clinical data of an adolescent child with refractory bronchial asthma in our hospital were retrospectively analyzed, and the literature was reviewed. Results: After regular atomization, plus Dupilumab combined with allergen specific immunotherapy, asthma and atopic dermatitis were well controlled, and ACT score, SCOARD score, PAQLQ score lung function were significantly improved. Conclusion: 1) Dupilumab combined with allergen specific immunotherapy has significant effect on refractory adolescent bronchial asthma and can also alleviate the clinical symptoms of atopic dermatitis. 2) Comprehensive management of adolescent children with bronchial asthma is crucial, and the combination of other type 2 inflammation will increase the difficulty of treatment. 3) Clinicians should pay attention to health education and emotional management of children in the process of routine treatment, to improve the transitional management level of adolescent bronchial asthma and promote the respiratory health management of the whole life cycle.展开更多
文摘目的:通过总结1例度普利尤单抗联合变应原特异性免疫疗法治疗青春期难治性支气管哮喘的临床资料,提高临床医生对青春期难治性哮喘的认识。方法:回顾性分析我院收治的1例青春期难治性支气管哮喘患儿的临床资料,并进行文献复习。结果:该患儿出院后规律雾化,加用度普利尤单抗联合变应原特异性免疫疗法治疗,支气管哮喘及特应性皮炎得到了良好控制,ACT评分、SCOARD评分、PAQLQ评分及肺功能得到明显的改善。结论:1) 度普利尤单抗联合变应原特异性免疫疗法对青春期难治性支气管哮喘疗效显著,同时可以缓解特应性皮炎的临床症状。2) 青春期支气管哮喘患儿的综合管理至关重要,合并其他2型炎症会增加其治疗难度。3) 临床医生在常规治疗的过程中需注重对患儿的健康教育和情绪管理,提高青春期支气管哮喘过渡管理水平,促进全生命周期的呼吸健康管理Objective: To improve the understanding of adolescent refractory asthma by summarizing the clinical data of a case of Dupilumab combined with allergen specific immunotherapy for adolescent refractory bronchial asthma. Methods: The clinical data of an adolescent child with refractory bronchial asthma in our hospital were retrospectively analyzed, and the literature was reviewed. Results: After regular atomization, plus Dupilumab combined with allergen specific immunotherapy, asthma and atopic dermatitis were well controlled, and ACT score, SCOARD score, PAQLQ score lung function were significantly improved. Conclusion: 1) Dupilumab combined with allergen specific immunotherapy has significant effect on refractory adolescent bronchial asthma and can also alleviate the clinical symptoms of atopic dermatitis. 2) Comprehensive management of adolescent children with bronchial asthma is crucial, and the combination of other type 2 inflammation will increase the difficulty of treatment. 3) Clinicians should pay attention to health education and emotional management of children in the process of routine treatment, to improve the transitional management level of adolescent bronchial asthma and promote the respiratory health management of the whole life cycle.
