| 摘要: |
| 目的:通过网状 Meta 分析方法探讨不同种类的血管扩张剂在治疗新生儿持续性肺动脉高压(PPHN)的有效性和安全
性。 方法:检索 PubMed、EMBase、the
Cochrane
Library、Web
of
Science、中国生物医学文献数据库、中国知网、万方、维普数据库中
有关血管扩张剂治疗 PPHN 的文献,检索时限均为建库至 2023 年 6 月 20 日。 通过 NoteExpress
3. 9 软件进行文献管理,利用
Stata
17. 0 软件对不同血管扩张剂治疗 PPHN 的有效性和安全性进行网状 Meta 分析。 结果:最终纳入 47 篇文献,包含 5 类药物
组成的 10 种治疗方案。 Meta 分析结果显示,各治疗方案在各种结局中的有效性排名不一致,磷酸二酯酶-5 抑制剂(PDE5i)+吸
入性一氧化氮(iNO)、前列腺素类似物和前列环素受体激动剂(PRA)整体评价较好;安全性方面,未观察到血管扩张剂的严重
不良反应。 结论:选用血管扩张剂在治疗 PPHN 时,PDE5i+iNO 组合可能是最优选择,但当 iNO 不可用时,可选西地那非;由于
本研究的局限性,结论尚需更多临床随机对照试验证实。 |
| 关键词: 新生儿持续性肺动脉高压 血管扩张剂 网状 Meta 分析 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2024.09.007 |
|
| 基金项目: |
|
| NetworkMeta-AnalysisonEfficacyandSafetyofVasodilatorsintheTreatmentofPersistentPulmonaryHypertensionofNewborn |
| Wu
Di
1,Ye
Tingting
2,Bao
Lei
1 |
| (1.
Children’ s
Hospital
of
Chongqing
Medical
University,
National
Clinical
Research
Center
for
Child
Health
and
Disorders,
Ministry
of
Education
Key
Laboratory
of
Child
Development
and
Disorders,
Chongqing
Key
Laboratory
of
Structural
Birth
Defect
and
Reconstruction,
Chongqing 400014,
China;
2.
Guizhou
Tongren
Maternity
and
Child
Health
Care
Hospital,
Guizhou
Tongren 554300,
China) |
| Abstract: |
| Objective:
To
probe
into
the
efficacy
and
safety
of
different
types
of
vasodilators
in
the
treatment
of
persistent
pulmonary
hypertension
of
newborn
( PPHN)
through
network
Meta-analysis.
Methods:
PubMed,
EMBase,
the
Cochrane
Library,
Web
of
Science,
CBM,
CNKI,
Wanfang,
and
VIP
databases
were
retrieved
to
collect
literature
related
to
vasodilators
in
the
treatment
of
PPHN.
The
retrieval
time
was
from
the
establishment
of
the
database
to
Jun.
20th,
2023.
NoteExpress
3. 9
software
was
used
for
literature
management,
and
Stata
17. 0
software
was
used
to
perform
network
Meta-analysis
on
efficacy
and
safety
of
different
vasodilators
in
the
treatment
of
PPHN.
Results:
A
total
of
47
articles
were
enrolled,
including
10
treatment
regimens
with
5
classes
of
drugs.
Meta-analysis
showed
inconsistent
ranking
results
of
each
treatment
regimen
in
various
outcomes.
The
combination
of
phosphodiesterase
type
5
inhibitor
(PDE5i)
+
inhaled
nitric
oxide
( iNO),
prostaglandin
analogs
and
prostanoid
analogues
( PRA)
had
better
overall
evaluations.
Regarding
safety,
no
severe
adverse
drug
reactions
of
vasodilators
were
observed.
Conclusion:
PDE5i
+
iNO
may
be
the
optimal
selection
in
the
treatment
of
PPHN,
yet
sildenafil
may
be
the
most
hopeful
option
in
the
treatment
of
PPHN
when
iNO
is
unavailable.
However,
due
to
certain
limitations,
more
clinical
randomized
controlled
trials
are
needed
in
the
future
for
further
confirmation. |
| Key words: persistent
pulmonary
hypertension
of
newborn vasodilators network
Meta-analysis |
