口服普萘洛尔治疗婴幼儿血管瘤的Meta分析  

Effectiveness of oral propranolol on infantile hemangiomas： a meta-analysis

作　　者：周生儒[1] 吕仁荣[1] 牛静静[1] 张林峰[1] 张丽丹[1] 霍然[1] 

机构地区：[1]山东大学附属省立医院烧伤整形科,济南250021

出　　处：《中华医学美学美容杂志》2015年第1期33-36,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：国家自然科学基金面上资助项目（81171828）

摘　　要：目的 以Meta分析方法对普萘洛尔治疗婴幼儿血管瘤的疗效和安全性与泼尼松进行比较,并进行系统评价.方法 检索Pubmed、Embase、Cochrane、Ovid、Google Scholar和中国期刊全文数据库、维普中文科技期刊数据库、万方医学数据库中普萘洛尔治疗婴幼儿血管瘤的文献,选择随机对照试验和临床对照试验文献进行分析.对通过筛选的文献进行Meta分析.结果 最终纳入8篇文献9项研究共计407例患者.普萘洛尔疗效优于泼尼松[比值比（OR）=7.56,95％置信区间（CI）：（3.18～17.98,P＜0.05）]及空白对照（OR=23.15,95％CI：7.15～74.94,P＜0.05）.普萘洛尔治疗血管瘤不良反应发生率低于泼尼松（OR=0.12,95 ％CI：0.02～0.75,P＜0.05）.结论 现有临床证据证明口服普萘洛尔治疗婴幼儿血管瘤的有效性及安全性优于口服泼尼松.Objective To assess the effectiveness and safety of propranolol in infantile hemangiomas by comparing with prednisone.Methods A systematic literature search of PubMed,Embase,Cochrane,Ovid,Google Scholar and CNKI,VIP,Wanfang database was conducted to identify studies about the treatment of propranolol in children with hemangiomas.We chose randomized controlled trials and clinical controlled trials.We selected literatures by certain standards.Results Eight papers including 9 studies were identified by the strategy mentioned above.These 8 literatures met our inclusion criteria after review by two independent reviewers.The studies comprised 407 patients.Six of the control group were oral prednisone,and there was no statistic heterogeneity （P =0.09,I2 =0％）.The fixed model was used to do the statistic analysis.The outcome showed the effective rate of propranolol was higher than that of prednisone,with statistically significant difference （OR=7.56,95％ CI：3.18-17.98）.Three of the control group included observation or oral placebo,without statistic heterogeneity （P=0.48,I2=0％） either.The outcome showed the effective rate of propranolol on hemangioma was higher than that of the control group （OR=23.15,95％CI：7.15-74.94）.Of all the eight researches,five reported adverse effects,with statistic heterogeneity （P=0.0003,I2 =81 ％）.In addition,the adverse rate of propranolol was lower than that of prednisone,with statistically significant difference （OR=0.12,95％ CI：0.02-0.75）.Conclusions The results of this meta-analysis show that oral propranolol could obviously decrease the volume and improve the color of infantile hemangiomas.And propranolol is a significantly more effective for IH than steroids.The incidence of adverse effects of propranolol is also lower than that of prednisone.As a result,propranolol should be recommended as the first choice therapy for infantile hemangioma.

关 键 词：血管瘤 普萘洛尔 META分析 

分 类 号：R732.2[医药卫生—肿瘤]