对乙酰氨基酚与布洛芬治疗早产儿动脉导管未闭有效性和安全性的Meta分析  

Efficacy and safety of paracetamol and ibuprofen for the treatment of premature infants with patent ductus arteriosus:a Meta-analysis

作　　者：曾缘缘 许静[1] ZENG Yuan-yuan;XU Jing(Nanjing Children's Hospital Affiliated to Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院,南京210008

出　　处：《中国新药杂志》2019年第23期2914-2920,共7页Chinese Journal of New Drugs

摘　　要：目的:系统性评估对乙酰氨基酚与布洛芬治疗早产儿动脉导管未闭(patent ductus arteriosus,PDA)的有效性和安全性的差异。方法:计算机检索Pubmed,The Cochrane Library,EMbase,中国知网、万方数据库以及维普期刊数据库,纳入研究布洛芬和对乙酰氨基酚治疗早产儿动脉导管未闭的随机对照试验(randomized controlled trials,RCTs)并通过Revman 5.3软件进行Meta分析。结果:最终纳入8篇研究,包括910例患儿。Meta分析的结果显示二者的动脉导管首次[95%CI:0.97~1.15,P=0.23]和最终关闭率[95%CI:0.97~1.11,P=0.31]以及对谷丙转氨酶(ALT)水平[95%CI:-0.05~0.26,P=0.19]和血肌酐水平(SCr)[95%CI:-0.33~0.05,P=0.14]的影响并无统计学差异。但是与布洛芬相比,对乙酰氨基酚可减少少尿[95%CI:0.18~0.74,P=0.005]和消化道出血的发生率[95%CI:0.18~0.82,P=0.01],且均有统计学差异。结论:当前证据表明,对乙酰氨基酚治疗PDA的疗效以及对ALT和SCr水平的影响与布洛芬无统计学差异,但是少尿和消化道出血的发生率低于布洛芬,且有统计学差异。Objective:To systematically investigate the safety and efficacy of paracetamol versus ibuprofen in the treatment of premature infants with patent ductus arteriosus(PDA).Methods:Databases including PubMed,The Cochrane Library,Embase,CNKI,WanFang Data and VIP database were searched to collect randomized controlled trials(RCTs)about paracetamol and ibuprofen for the treatment of premature infants with patent ductus arteriosus.This meta-analysis was conducted by Revman 5.3 software.Results:A Total of 8 RCTs were included in this study,involving 910 premature infants.The results showed that the primary PDA closure rate[95%CI:0.97~1.15,P=0.23]and overall PDA closure rate[95%CI:0.97~1.11,P=0.31]of paracetamol had no statistically significant difference compared with ibuprofen.And no statistical difference on the levels of ALT[95%CI:-0.05~0.26,P=0.19]and SCr[95%CI:-0.33~0.05,P=0.14]were observed,but paracetamol can significantly decrease oliguria rate[95%CI:0.18~0.74,P=0.005]and gastrointestinal bleeding rate[95%CI:0.18~0.82,P=0.01]compared with ibuprofen.Conclusion:Current evidence shows that there is no statistical difference in PDA closure rate between paracetamol and ibuprofen,and that also on the levels of SCr and ALT.But paracetamol can significantly decrease oliguria rate and gastrointestinal bleeding rate compared with ibuprofen.

关 键 词：动脉导管未闭 对乙酰氨基酚 布洛芬 META分析 早产儿 

分 类 号：R972[医药卫生—药品]