沙丁胺醇治疗孕妇早产的系统评价  

Salbutamol in Preventing Preterm Labour: A Systematic Review

作　　者：闵光宁[1] 刘芳[1] 翟所迪[1] 朱劲松[2] 张虹[3] 王婷[3] 闵光涛[4] 

机构地区：[1]北京大学第三医院药剂科,北京100083 [2]兰州大学第一医院妇产科 [3]兰州大学第一医院药剂科,兰州730000 [4]兰州大学第一医院普外科

出　　处：《中国循证医学杂志》2007年第8期591-600,共10页Chinese Journal of Evidence-based Medicine

摘　　要：目的评价沙丁胺醇治疗孕妇早产的疗效与安全性。方法计算机检索MEDLINE（1966～2007.1）、EMbase（1966～2007.1）、Cochrane对照试验资料库（2006年第4期）、CBMdisc（1978～2007.1）和CNKI（1979～2007.1）,收集沙丁胺醇治疗早产的随机和半随机试验,对符合纳入标准的临床研究进行Meta分析。结果共纳入19篇随机和半随机试验,其中中文16篇,英文3篇。未检索到关于此题目的其他语种研究报告。16项中文研究的Jadad改良法评分均〈3分,为低质量文献,各研究均未描述具体的随机方法,未进行分配方案的隐藏,未使用盲法,未对远期效果进行评价。3篇英文研究的Jadad改良法评分〉5分,对远期效果进行了评价,为高质量文献。与基础治疗相比,沙丁胺醇组保胎超过48h的人数较高[RR（95%CI）为6.30（3.23,14.32）]、新生儿窒息率较低[RR（95%CI）为0.44（0.33,0.59）],但孕妇不良事件发生率高于基础治疗组[RR（95%CI）为4.57（1.34,15.54）]。与硫酸镁组相比,沙丁胺醇组保胎超过48h的孕妇数、新生儿窒息率OR（95%CI）分别为1.60（0.92,2.76）,0.29（0.14,0.61）。与阿托西班相比,沙丁胺醇保胎超过48h的孕妇数、新生儿窒息率OR（95%CI）分别为1.18（0.42,3.37）,1.13（0.30,4.31）。结论与基础治疗相比,沙丁胺醇在提高保胎成功率、降低新生儿窒息率方面优于后者,但孕妇不良事件发生率较基础治疗高;沙丁胺醇与其他常用保胎药相比,在保胎成功率方面无明显差异,在降低新生儿窒息率方面优于硫酸镁,孕妇不良事件较阿托西班高,较硫酸镁低。Objective To assess the effectiveness and safety of salbutamol in the treatment of preterm labor. Methods We searched MEDLINE （1966-Jan. 2007）, EMBASE （1966-Jan. 2007）, Cochrane Central Register of Controlled Trials （Issue 4, 2006）, CBMdisc （1978-Jan. 2007） and CNKI （1979-Jan. 2007）. Randomized controlled trials （RCTs） or quasi-randomized controlled trials （quasi-RCT） involving salbutamol for preterm labor were collected. The quality of the retrieved trials was assessed using the Jadad Scale. Meta-analyses were conducted with The Cochrane Collaboration＇s RevMan 4.2 software. Results A total of 19 RCTs and quasi-RCTs were included, of which 16 were published in Chinese and 3 in English. The quality of the 16 Chinese studies was low, scored less than 3 by the Jadad Scale. None of the 16 RCTs mentioned the method of randomization, allocation concealment, doubleblinding or the long-term effect. The quality of the 3 English studies was high. Compared with basic treatment, salbutamol was more effective in prolonging pregnancy over 48 hours （RR=6.30, 95%CI 3.23 to 14.32）, and preventing neonatal asphyxia （RR=0.44, 95%CI 0.33 to 0.59）, but the incidence of adverse events in pregnant women was higher in the salbutamol group （RR=4.57, 95%CI 1.34 to 15.54）. Salbutamol was as effective as magnesium sulfate in prolonging pregnancy over 48 hours （OR=1.60, 95%CI 0.92 to 2.76）, but more effective in preventing neonatal asphyxia （OR=0.29, 95%CI 0.14 to 0.61）. Salbutamol was similar to atosiban in terms of prolonging pregnancy over 48 hours （OR=1.18, 95%CI 0.42 to 3.37） and preventing neonatal asphyxia （OR=1.13, 9S%CI 0.30 to 4.31）. Conclusion Salbutamol is effective in prolonging pregnancy over 48 hours and preventing neonatal asphyxia, but may cause more adverse events in pregnant women. Salbutamol has similar effects to other commonly-used drugs in regard to prolonging pregnancy over 48 hours, but is better than magnesium sulfate in decreasing the incidence of neonatal a

关 键 词：沙丁胺醇 早产 系统评价 

分 类 号：R714.21[医药卫生—妇产科学]