背景:哮喘是一种以慢性气道炎症为特征的疾病,然而,三分之一的哮喘病例没有充分反应。已提出吸入镁作为无反应性哮喘病例的治疗方法。然而,其作用仍有争议。这篇综述评估了雾化镁与标准治疗相比的有效性和安全性(β激动剂,抗胆碱能,皮质类固醇)在成人急性哮喘发作中。
方法:该协议已在PROSPERO中注册。通过PubMed/MEDLINE进行了文献检索,科克伦,ProQuest,和谷歌学者,并使用关键词“吸入镁”和“哮喘”。通过数据门户进行了手动搜索。期刊文章包括随机对照试验。偏倚风险评估使用Cochrane偏倚风险工具的第2版进行随机试验。
结果:这篇综述包括五篇文章。与对照组相比,镁组的再入院率和氧饱和度没有显着差异(RR1;95%CI0.92至1,08;p=0,96和MD1,82;95%CI-0.89至4.53;p=0.19,分别)。镁的呼吸频率和临床严重程度显着降低(MD-1,72;95%CI-3,1至0.35;p=0.01,RR0.29;95%CI0.17至0.69;p<0.001)。镁组有较高的副作用风险(HR1.56;95CI1.05至2.32;p=0.03)。然而,副作用相对轻微,如低血压和恶心。
结论:吸入镁可改善哮喘患者的预后,特别是在肺功能方面,临床严重程度,和呼吸频率。此外,吸入镁是安全的。
BACKGROUND: Asthma is a disease characterized by chronic airway inflammation, however one-third of asthmatic cases did not respond adequately. Inhaled magnesium has been proposed as a treatment for unresponsive asthma cases. However, its role remains controversial. This
review evaluates the effectiveness and safety of nebulized magnesium compared to standard therapy (Beta Agonist, Anticholinergic, Corticosteroid) in adults with acute asthma attacks.
METHODS: The protocol has been registered in PROSPERO. A literature search was conducted through PubMed/MEDLINE, Cochrane, ProQuest, and Google Scholar, and using the keywords \"inhaled magnesium\" and \"asthma\". Manual searches were carried out through data portals. Journal articles included are randomized controlled trials. The assessment risk of bias was performed using Version 2 of the Cochrane risk-of-bias tool for randomized trials.
RESULTS: There are five articles included in this
review. There is no significant difference in readmission rate and oxygen saturation in the magnesium group compared to control (RR 1; 95% CI 0.92 to 1,08; p= 0,96 and MD 1,82; 95% CI -0.89 to 4.53; p= 0.19, respectively). There is a significant reduction of respiratory rate and clinical severity in magnesium (MD -1,72; 95% CI -3,1 to 0.35; p= 0.01, RR 0.29; 95% CI 0.17 to 0.69; p <0.001, respectively). There was a higher risk of side effects in the magnesium group (HR 1.56; 95%CI 1.05 to 2.32; p= 0.03). However, the side effects are relatively mild such as hypotension and nausea.
CONCLUSIONS: Inhaled magnesium improves the outcome of asthmatic patients, especially in lung function, clinical severity, and respiratory rate. Moreover, inhaled magnesium is safe to be given.