發(fā)布時(shí)間：2018-12-12 17:29

【摘要】：目的探討早期應(yīng)用糖皮質(zhì)激素預(yù)防早產(chǎn)兒支氣管肺發(fā)育不良(BPD)的療效和安全性。方法全面檢索Pub Med、Cochrane Library、Embase、相關(guān)期刊論文(CNKI)、萬(wàn)方醫(yī)學(xué)網(wǎng)及維普等數(shù)據(jù)庫(kù),收集各數(shù)據(jù)庫(kù)從建庫(kù)至2016年6月有關(guān)早產(chǎn)兒早期應(yīng)用糖皮質(zhì)激素預(yù)防BPD的文獻(xiàn),對(duì)符合納入標(biāo)準(zhǔn)的16項(xiàng)隨機(jī)對(duì)照試驗(yàn)(RCT)應(yīng)用Review Manager 5.3進(jìn)行Meta分析。結(jié)果 16項(xiàng)RCT共納入2 962例參與者,其中試驗(yàn)組1 486例,對(duì)照組1 476例。Meta分析結(jié)果顯示,早產(chǎn)兒早期應(yīng)用糖皮質(zhì)激素有利于減少糾正胎齡36周時(shí)BPD的發(fā)生率(OR=0.73,95%CI:0.61~0.87,P=0.0004);但發(fā)生高血糖(OR=1.61,95%CI:1.24~2.09,P=0.0003)、高血壓(OR=1.63,95%CI:1.11~2.38,P=0.01)、腸穿孔(OR=1.51,95%CI:1.12~2.04,P=0.007)的風(fēng)險(xiǎn)增加。結(jié)論目前尚不能推薦早產(chǎn)兒應(yīng)用糖皮質(zhì)激素預(yù)防BPD,需要進(jìn)一步研究其優(yōu)缺點(diǎn),尤其需注意高血糖、高血壓、腸穿孔等不良影響。
[Abstract]:Objective to investigate the efficacy and safety of early application of glucocorticoid in the prevention of bronchopulmonary dysplasia (BPD) in premature infants. Methods Pub Med,Cochrane Library,Embase, Chinese periodical full-text database, (CNKI), Wanfang Medical Network and Wiper, were searched, and the literatures on early application of glucocorticoid to prevent BPD in premature infants were collected from the establishment of the database to June 2016. Review Manager 5.3 was applied to Meta analysis of 16 randomized controlled trials (RCT) that met the inclusion criteria. Results A total of 2 962 participants were included in 16 items of RCT, including 1 486 cases in the trial group and 1 476 cases in the control group. Early use of glucocorticoid in preterm infants was helpful to reduce the incidence of BPD (OR=0.73,95%CI:0.61~0.87,P=0.0004) at 36 weeks of corrected gestational age. But the risk of hyperglycemia (OR=1.61,95%CI:1.24~2.09,P=0.0003), hypertension (OR=1.63,95%CI:1.11~2.38,P=0.01), and intestinal perforation (OR=1.51,95%CI:1.12~2.04,P=0.007) is increased. Conclusion it is not recommended to use glucocorticoid in preterm infants to prevent BPD,. It is necessary to further study its advantages and disadvantages, especially the adverse effects of hyperglycemia, hypertension and intestinal perforation.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬上海兒童醫(yī)學(xué)中心呼吸內(nèi)科;
【分類號(hào)】：R722.6

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳丹;黃西林;李小萍;;新生兒壞死性小腸結(jié)腸炎危險(xiǎn)因素的Meta分析[J];中華臨床醫(yī)師雜志(電子版);2010年05期

2 呂彩蘭;戴恩來(lái);吳建軍;魏錦慧;徐厚謙;;中西醫(yī)結(jié)合治療小兒原發(fā)性腎病綜合征隨機(jī)對(duì)照試驗(yàn)的Meta分析[J];華中科技大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2013年01期

3 肖彥;尚如國(guó);;保守治療與手術(shù)治療兒童肱骨髁上骨折療效的Meta分析[J];新中醫(yī);2013年02期

4 單炯;陶芳芳;陳夏芳;何振娟;;極低出生體質(zhì)量?jī)簯?yīng)用持續(xù)喂養(yǎng)或間斷喂養(yǎng)的meta分析[J];臨床兒科雜志;2010年03期

5 馬利敏;趙小強(qiáng);劉洪超;阮林海;馮艷銘;;亞甲基四氫葉酸還原酶基因多態(tài)性與中國(guó)兒童急性淋巴細(xì)胞白血病關(guān)系的Meta分析[J];醫(yī)學(xué)研究雜志;2014年04期

6 葉庭妤,肖昕,熊愛(ài)華,徐春光;納絡(luò)酮佐治新生兒缺氧缺血性腦病臨床效果的Meta分析[J];中國(guó)當(dāng)代兒科雜志;2004年02期

7 盧靜;于文韜;馬云琪;徐s，

本文編號(hào)：2375000