早产儿生后早期应用糖皮质激素预防支气管肺发育不良的Meta分析

发布时间：2018-12-12 17:29

【摘要】：目的探讨早期应用糖皮质激素预防早产儿支气管肺发育不良(BPD)的疗效和安全性。方法全面检索Pub Med、Cochrane Library、Embase、相关期刊论文(CNKI)、万方医学网及维普等数据库,收集各数据库从建库至2016年6月有关早产儿早期应用糖皮质激素预防BPD的文献,对符合纳入标准的16项随机对照试验(RCT)应用Review Manager 5.3进行Meta分析。结果 16项RCT共纳入2 962例参与者,其中试验组1 486例,对照组1 476例。Meta分析结果显示,早产儿早期应用糖皮质激素有利于减少纠正胎龄36周时BPD的发生率(OR=0.73,95%CI:0.61~0.87,P=0.0004);但发生高血糖(OR=1.61,95%CI:1.24~2.09,P=0.0003)、高血压(OR=1.63,95%CI:1.11~2.38,P=0.01)、肠穿孔(OR=1.51,95%CI:1.12~2.04,P=0.007)的风险增加。结论目前尚不能推荐早产儿应用糖皮质激素预防BPD,需要进一步研究其优缺点,尤其需注意高血糖、高血压、肠穿孔等不良影响。
[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.
【作者单位】：上海交通大学医学院附属上海儿童医学中心呼吸内科;
【分类号】：R722.6

【相似文献】