中国循证儿科杂志 ›› 2017, Vol. 12 ›› Issue (6): 429-433.

• 论著 • 上一篇    下一篇

早产儿生后补充维生素A可预防支气管肺发育不良:基于6篇随机对照试验的Meta分析

陈丹丹,朱雪萍   

  1. 苏州大学附属儿童医院新生儿科苏州,215000
  • 收稿日期:2017-07-26 修回日期:2017-12-22 出版日期:2017-12-25 发布日期:2017-12-25
  • 通讯作者: 朱雪萍,E-mail: zhuxueping4637@hotmail.com

Vitamin A supplementation in the prevention and treatment of bronchopulmonary dysplasia in premature infants: a meta-analysis based on 6 randomized control trial

CHEN Dan-dan,ZHU Xue-ping   

  1. Children's Hospital affiliated to Soochow University,Suzhou 215000,China
  • Received:2017-07-26 Revised:2017-12-22 Online:2017-12-25 Published:2017-12-25
  • Contact: ZHU Xue-ping, E-mail: zhuxueping4637@hotmail.com

摘要: 摘要 目的:系统评价维生素A (VitA)防治早产儿支气管肺发育不良(BPD)的有效性及安全性。方法:计算机检索PubMed、EMBASE、Cochrane图书馆临床对照试验资料库、中国期刊全文数据库(CNKI)、中国科技期刊数据库(维普)和万方数字化期刊全文数据库,收集已发表的VitA防治早产儿(胎龄<37周)BPD的RCT。检索时间均为建库至2017年10月1日,同时采用主题词和自由词进行检索。主要结局指标为BPD发生率和出院前病死率;次要结局指标包括早产儿视网膜病变(ROP)、动脉导管未闭(PDA)和脑室内出血(IVH)发生率,住院,吸氧,机械通气时间,治疗过程中的不良反应。使用Cochrane手册对纳入研究的RCT进行偏倚风险评估,采用Revman 5.3软件进行统计分析。结果:共纳入6篇英文RCT 1 170例早产儿,给药方式5篇为肌肉注射,1篇为胃管给药。6篇均描述了随机序列的产生方法,均提及分配隐藏,均无结局数据缺失和选择性报告结果,5篇采用双盲法。Meta分析结果显示,VitA组较对照组主要结局指标BPD发生率[OR=0.67,95%CI:0.52~0.87]差异有统计学意义, 病死率[OR=1.05,95%CI:0.77~1.44]差异无统计学意义;次要结局指标ROP、PDA、IVH、住院时间、机械通气时间、吸氧时间和不良反应(败血症、呕吐、抽搐)差异均无统计学意义。结论:早产儿生后补充VitA可降低BPD发生率。

Abstract: AbstractObjective: To assess the effectiveness and safety of vitaminA(VitA) for Preventing bronchopulmonary dysplasia (BPD) in preterm infants systematically. Methods: The PubMed, EMBASE,Cochrane LibraryClinical controlled trial database, Chinese Journals full-text Database (CNKI), Chinese Technological Journals Database (VIP) and Wan Fang Digital Journal Full-text Database were searched for randomised control trials (RCTS) on whether VitA could prevent BPD in preterm infants (<37 weeks of gestational age) . The retrieval time was from inception to Oct.2017,at the same time, MESH and free words were used to retrieve. The primary outcome was the incidence of BPD and mortality before discharge; secondary outcomes included the rate of retinopathy of prematurity (ROP), patent ductus arteriosus (PDA) and intraventricular hemorrhage (IVH), hospitalization time, oxygen time, mechanical ventilation time, adverse reactions during the treatment. Bias risk was assessed based on the Cochrane handbook for systemic reviews. Revman 5.3 software was used for meta-analysis.Results: A total of 6 RCTS (both in English) including 1170 preterm infants met the inclusion criteria. The way of administration was intramuscular injection except a study's way was gastric tube. 6 articles all described the method of generating random sequences, all of them referred to allocation concealment, no ending data loss or selective report results, and 5 trials used the double blind method. Meta-analysis showed that the incidence of BPD in VitA group was lower than that in control group [OR=0.67, 95%CI: 0.52~0.87 and P=0.003]. There was no significant difference in the mortality before discharge[OR=1.05,95%CI:0.77~1.44,P=0.76], as well as in the secondary outcomes, including the incidences of ROP, PDA, IVH, adverse reactions, hospitalization time, mechanical ventilation time, and oxygen time, between the two groups. Conclusion: VitA can reduce the incidence of BPD.

中图分类号: