氨甲喋呤联合米非司酮治疗异位妊娠的Meta分析  

Combined use of methotrexate and mifepristone for ectopic pregnancy management:a meta-analysis

作　　者：宋华东[1] 陈士岭[1] 何锦霞[1] 裘毓雯[1] 

机构地区：[1]南方医科大学南方医院妇产科,广东广州510515

出　　处：《南方医科大学学报》2006年第12期1815-1817,共3页Journal of Southern Medical University

摘　　要：目的评价氨甲喋呤联合米非司酮治疗异位妊娠的有效性和安全性。方法按照循证医学的要求全面检索中国知识期刊网(1994.1-2005.5)、中国生物医学光盘数据库(1995.1-2005.5)及Pubmed(1995.1-2005.5),收集氨甲喋呤联合米非司酮与单用氨甲喋呤治疗异位妊娠的随机对照试验。结果检索到符合纳入标准的随机对照试验文章23篇,共1706例病人。Meta分析结果显示,氨甲喋呤联合米非司酮能有效治疗异位妊娠[OR合并=2.84,95%CI(2.18,3.69),P=0.0000]。在森林图中,OR合并的95%CI横线落在无效竖线右侧,可认为氨甲喋呤联合米非司酮治疗异位妊娠有效。结论目前较低质量研究的Meta分析提示,氨甲喋呤联合米非司酮治疗异位妊娠与单用氨甲喋呤比较,疗效的差异有高度显著性;在森林图中,,OR合并的95%CI横线落在无效竖线右侧,可认为氨甲喋呤联合米非司酮治疗异位妊娠有效,安全性可能较高,副作用较小,但还需要严格设计的、大样本的随机双盲对照试验来进一步验证和支持。Objective To evaluate the clinical effect and safety of combined use of methotrexate and mifepristone for treatment of ectopic pregnancy. Methods By searching in the major databases of CNKI, CBMdisk and Pubmed according to the criteria of evidence-based medicine, we collected data of randomized controlled trials pertaining to combined use of methotrexate and mifepristone in the treatment of ectopic pregnancy. Results Twenty-three randomized controlled trials involving totally 1 706 patients were collected according to the inclusion criteria, and meta-analysis of the data indicated that combined use of methotrexate and mifepristone can be of great value in the management of ectopic pregnancy in comparison with exclusive use of methotrexate [combined odds ratio （OR） was 2.84 with 95% confidence interval [CI] （2.18, 3.69）, Z=7.79, P〈0.000 01 ]. Conclusions The clinical evidence derived from the analysis suggests that the combination of methotrexate and mifepristone for ectopic pregnancy management can be effective with good safety security and minimal side effects, but still, this conclusion needs further verification by randomized, double-blind, and controlled trials with larger sample size and more rigorous trial design.

关 键 词：氨甲喋呤 米非司酮 异位妊娠 META分析 

分 类 号：R714.22[医药卫生—妇产科学] R195.4[医药卫生—临床医学]