硝苯地平对比肼屈嗪治疗重度子痫前期患者的疗效与安全性的系统评价  

Systematic Review of Therapeutic Efficacy and Safety of Nifedipine versus Hydralazine for Severe Preeclampsia

作　　者：张培[1] 王海琳[2] 张恒亮[1] 

机构地区：[1]兰州大学第一临床医学院,兰州730000 [2]甘肃省人民医院妇产科,兰州730000

出　　处：《中国药房》2013年第40期3801-3804,共4页China Pharmacy

摘　　要：目的:系统评价硝苯地平对比肼屈嗪治疗重度子痫前期患者的疗效和安全性。方法:计算机检索中国生物医学文献数据库、维普数据库、万方数据库、中国期刊全文数据库、PubMed、EMbase和Cochrane图书馆,纳入硝苯地平对比肼屈嗪(肼苯哒嗪)治疗重度子痫前期患者的随机对照试验(RCT),提取资料后,采用Rev Man 5.0统计学软件进行Meta分析。结果:纳入7项RCT,共587例患者。Meta分析结果显示,硝苯地平组在降压显效时间[WMD=-4.66,95%CI(-12.98,3.66),P=0.27]、新生儿5 min Apgar评分[WMD=0.10,95%CI(-0.14,0.34),P=0.42]、患者剖宫产比例[OR=0.76,95%CI(0.45,1.29),P=0.32]和患者不良反应发生率方面,与肼屈嗪组比较差异均无统计学意义;但硝苯地平组首次给药降压成功率[OR=2.70,95%CI(1.73,4.23),P<0.01]高于肼屈嗪组,两组比较差异有统计学意义。结论:重度子痫前期患者应用硝苯地平后降压显效时间、新生儿5 min Apgar评分和剖宫产比例方面,与应用肼屈嗪比较无显著性差异,但首次给药降压成功率优于肼屈嗪。此结论尚需更多大样本、高质量的RCT加以验证。OBJECTIVE： To evaluate therapeutic efficacy and safety of nifedipine vs. hydralazine for severe preeclampsia. METHODS： Retrieved from CBM, VIP, Wanfang database, CNKI, PubMed, EMbase and Cochrance library, randomized controlled trials （RCT） on nifedipine vs. hydralazine in the treatment of severe preeclampsia were included After extracting the data, Meta-analysis was performed using Rev Man 5.0 software. RESULTS： A total of 7 RCT were included, involving 587 patients. Re- suits of Meta-analysis showed that there were no statistical significance in the differences between nifedipine group and hydralazine group in response time of lowering blood pressure [WMD=-4.66, 95%CI （-12.98, 3.66）, P=0.27], Apgar score 5 min after birth [WMD=0.10, 95%CI （-0.14, 0.34）, P=0.42], the proportion of cesarean section [OR=0.76, 95%CI （0.45, 1.29）, P= 0.32] and side effect. However, the successful rate of lowering blood pressure after initial medication [OR=2.70, 95% CI （1.73, 4.23）, P〈：0.01] in nifedipine group was significantly better than in hydralazine group. CONCLUSIONS： Nifedipine is as effective as hydralazine in response time of lowering blood pressure, Apgar score 5 min after birth and the proportion of cesarean section. Nifedipine is better than hydralazine in successful rate of lowering blood pressure after initial administration. And this conclusion still needs to be further proved by more large-scale and high quality clinical trials.

关 键 词：硝苯地平 肼屈嗪 子痫前期 随机对照试验 系统评价 

分 类 号：R714[医药卫生—妇产科学]