西地那非治疗新生儿持续性肺动脉高压的系统分析  

Meta-analysis of the effects of sildenafil on newborns with persistent pulmonary hypertension

作　　者：张耀东[1] 谭利娜[2] 王彩君[1] 刘大鹏[1] 金娟[1] 郭静[1] 许帮礼[1] 康文清[1] 孙慧清[1] 熊虹[1] 

机构地区：[1]郑州市儿童医院新生儿监护病房(NICU),河南郑州450052 [2]郑州市儿童医院心胸外科,河南郑州450052

出　　处：《中国医院药学杂志》2014年第22期1933-1938,共6页Chinese Journal of Hospital Pharmacy

摘　　要：目的:从循证医学的角度探讨西地那非治疗新生儿持续性肺动脉高压(PPHN)的临床疗效。方法:检索中国期刊网、万方数据库、中国生物医学文献数据库,获得已发表的西地那非治疗新生儿PPHN的相关文献。根据临床纳入和排除标准,利用Revman 5.1软件对符合纳入条件的文献进行合并分析,以评价西地那非治疗新生儿PPHN时对患儿的治愈率、动脉氧分压、二氧化碳分压、氧合指数、肺动脉压及血压的影响。结果:共检索到符合纳入条件的文献9篇,其中西地那非组共257例,对照组239例。Meta分析结果提示西地那非治疗新生儿PPHN时的治愈率、氧分压、二氧化碳分压、氧合指数、肺动脉压及血压的文献进行合并分析,结果 OR值(95%CI)为2.48(95%CI,1.51~4.06),11.04(95%CI,6.03~16.04),-6.39(95%CI,-11.02^-2.83),5.46(95%CI,-19.16^-30.08),-9.81(95%CI,-18.18^-1.43),3.73(95%CI,-2.18~9.64.43),Z=3.61,4.32,3.32,0.43,2.30,1.24,P<0.001,P<0.0001,P<0.001,P>0.05,P<0.001,P>0.05,且各研究均无偏倚。结论:西地那非能够通过提高患儿氧分压,降低二氧化碳分压及肺动脉压力,以提高新生儿PPHN的治愈率,但对患儿的氧合功能与体循环血压无影响。OBJECTIVE To investigate the clinical efficacy of sildenafil on persistent pulmonary hypertension（PPHN）in the newborns from the perspective of evidence-based medicine.METHODS China Journal Net,Wanfang DATA,Chinese Biomedical Literature Database were retrieved to find the relevant literature published about PPHN treated with sildenafil in newborns.According to the clinical inclusion and exclusion criteria,the software of Revman5.1 was used to merger analysis of literature which met the inclusion criteria and to evaluate the cure rate,the arterial partial pressure of oxygen,carbon dioxide partial pressure,oxygenation index,blood pressure,pulmonary artery pressure of neonatal PPHN with sildenafil treatment.RESULTS A total 9 literatures met the inclusion criteria for Meta-analysis,including the sildenafil group 257 cases and the control group 239 cases.the results of the OR（95% CI）of cure rate,the partial pressure of oxygen,carbon dioxide partial pressure,oxygenation index,blood pressure,pulmonary artery pressure of neonatal PPHN with sildenafil treatment were 2.48（95%CI,1.51-4.06）,11.04（95%CI,6.03-16.04）,-6.39（95%CI,-11.02--2.83）,5.46（95%CI,-19.16--30.08）,-9.81（95%CI,-18.18--1.43）,3.73（95% CI,-2.18--9.64.43）,Z=3 61,4 32,3 32,0 43,2 30,1.24,P〈0.001,P〈0.0001,P〈0.001,P〉0.05,P〈0.001,P〉0.05.There was no bias in every study published.CONCLUSION Sildenafil can improve the cure rate of PPHN newborns by increasing the oxygen partial pressure and reducing carbon dioxide partial pressure and pulmonary artery pressure,but had no effect on the oxygenation and blood circulation.

关 键 词：西地那非 新生儿 持续性肺动脉高压 META分析 

分 类 号：R972[医药卫生—药品]