西地那非治疗新生儿持续性肺动脉高压的系统评价

发布时间：2018-03-10 06:06

本文选题：西地那非　切入点：持续性肺动脉高压　出处：《中国药房》2017年09期 　论文类型：期刊论文

【摘要】：目的:系统评价西地那非治疗新生儿持续性肺动脉高压(PPHN)的临床疗效,为临床提供循证参考。方法:计算机检索Pub Med、Cochrane图书馆、EMBase(Ovid)、中国生物医学文献数据库、相关期刊论文、万方数据库和中文科技期刊数据库,收集西地那非(试验组)对比基础治疗或安慰剂治疗PPHN的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取,并参考Cochrane系统评价员手册5.1.0进行质量评价,然后采用Rev Man 5.1统计软件进行Meta分析。结果:共纳入6项RCT,合计210例患儿。Meta分析结果显示,与安慰剂比较,西地那非治疗PPHN可以显著降低患儿的病死率[RR=0.16,95%CI(0.05,0.45),P0.001]和氧合指数[2 h后:MD=-12.80,95%CI(-20.11,-5.49),P0.001;24 h后:MD=-19.41,95%CI(-24.81,-14.00),P0.001],差异均有统计学意义;与基础治疗比较,西地那非治疗PPHN可以显著降低患儿肺动脉压[2 h后:MD=-22.36,95%CI(-24.89,-19.83),P0.001;24 h后:MD=-29.43,95%CI(-31.12,-27.74),P0.001],差异均有统计学意义,但对病死率无显著影响[RR=0.64,95%CI(0.30,1.39),P=0.26]。结论:西地那非治疗PPHN疗效较好,可以显著降低患儿的氧合指数、肺动脉压和病死率。
[Abstract]:Objective: to evaluate the clinical efficacy of sildenafil in the treatment of persistent pulmonary hypertension (PPH) in neonates, and to provide evidence based reference for clinical application. Methods: the Pub Med#en0# Cochrane Library, the Chinese Biomedical Literature Database, and the full text Database of Chinese Journals were searched by computer. Wanfang database and Chinese scientific and technological journal database were collected to collect sildenafil (trial group) to compare the randomized controlled trials of basic therapy or placebo treatment with PPHN, and to extract the data of clinical studies that met the inclusion criteria. The quality evaluation was carried out with reference to the Cochrane system evaluator's manual 5.1.0, and then the Meta analysis was performed with Rev Man 5.1 statistical software. Results: a total of 6 items were included. The results of meta analysis showed that the results were compared with placebo. Sildenafil treatment with PPHN significantly reduced the mortality of children [RRR 0.1695 CI 0.050.45% P0.001] and oxygenation index [2 hours later: MD-12.80 + 95CI-20.11C -5.49C P0.001T 0.001h later (P 0.001), the difference was statistically significant compared with that of basic therapy, the difference was significant (P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001, P 0.001). Sildenafil treatment with PPHN significantly decreased pulmonary artery pressure in children [2 h later: MD-24.89U -19.83N P0.001C 24 h later, the difference was statistically significant, but had no significant effect on mortality [RR0.6495CIT 0.300.301.39P0.26] conclusion: sildenafil has better therapeutic effect on PPHN, and can significantly reduce the oxygen index of the children, and has no significant effect on the mortality rate of the children [RRR0.6495CIT 0.301.39P0.26] conclusion: the therapeutic effect of sildenafil on PPHN is better, and it can significantly reduce the oxygen index of the children. Pulmonary artery pressure and mortality.
【作者单位】：四川大学华西药学院;四川大学华西第二医院药学部;四川大学华西第二医院循证药学中心;出生缺陷与相关妇儿疾病教育部重点实验室;四川大学华西第二医院儿科教研室;
【基金】：国家自然科学基金资助项目(No.81373381)
【分类号】：R722.1

【相似文献】