类固醇治疗极早产儿或极低体重儿支气管肺发育不良对神经发育影响的Meta分析  

Effects of Steroids for the Prevention of Bronchopulmonary Dysplasia on Neurodevelopment in Extremely Low Gestationalage Neonates or Low Birth Weight Premature Infants:a Meta-analysis

作　　者：孙洁雨 倪明明 吴文文[2] 韦冠[3] SUN Jieyu;NI Mingming;WU Wenwen;WEI Guan(Department of Pharmacy,The First Affiliated Hospital With Nanjing Medical University,Nanjing 210029;Department of Pharmacy,Children’s Hospital of Nanjing Medical University,Nanjing 210008;School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing 211198,China)

机构地区：[1]南京医科大学第一附属医院药学部,南京210029 [2]南京医科大学附属儿童医院药学部,南京210008 [3]中国药科大学国际医药商学院,南京211198

出　　处：《医药导报》2020年第8期1142-1147,共6页Herald of Medicine

摘　　要：目的系统评价类固醇用于治疗极早产儿或极低体质量儿支气管肺发育不良对神经发育的影响。方法计算机检索Pubmed、The Cochrane Library、EMbase以及中国期刊全文数据库,收集类固醇治疗极早产儿或极低体质量儿支气管肺发育不良的随机对照试验,同时辅以手工检索,评价纳入研究质量,合并结果进行Meta分析。结果共纳入12项试验,合计3341例患儿,试验组在脑瘫例数[RR=1.04,95%CI=(0.74,1.48),P=0.81]、智力发育指数[SMD=-0.18,95%CI=(-0.67,0.31),P=0.48]、神经运动发育指数[SMD=-0.25,95%CI=(-0.84,0.35),P=0.42]、认知迟缓人数[RR=0.77,95%CI=(0.40,1.50),P=0.44]、视觉障碍人数[RR=0.87,95%CI=(0.55,1.38),P=0.56]、听觉障碍人数[RR=0.42,95%CI=(0.16,1.07),P=0.07]、语言障碍人数[RR=0.85,95%CI=(0.46,1.56),P=0.60]、囊性脑室周围白质软化[RR=1.07,95%CI=(0.66,1.75),P=0.78]和严重脑室内出血[RR=0.95,95%CI=(0.72,1.24),P=0.70]方面与对照组相比,差异均没有统计学意义。结论使用低剂量的皮质类固醇治疗极早产儿或极低体质量儿支气管肺发育不良,对神经发育没有产生显著的不良影响。Objective To systematically evaluatethe influence of steroids inthe treatment of bronchopulmonary dysplasia on neuro-development in extremely low gestationalage neonates or low birth weight premature infants.Methods Retrieved from Pubmed,The Cochrane Library,EMbase,and CJFD database,the randomized controlled trials(RCT)about the effects of steroids for the prevention of bronchopulmonary dysplasia on neurodevelopment in extremely low gestationalage neonates or low birth weight premature infants were collected,with the supplemental search by manual retrieval..Quality evaluation and meta-analysis of included literatures were conducted.Results A total of 12 RCTs were included,involving 3341 cases.Results of meta-analysis showed that the number of patients with cerebral palsy[RR=1.04,95%CI=(0.74,1.48),P=0.81],cognitive delay[RR=0.77,95%CI=(0.40,1.50),P=0.44],visual impairment[RR=0.87,95%CI=(0.55,1.38),P=0.56],auditory impairment[RR=0.42,95%CI=(0.16,1.07),P=0.07],language impairment[RR=0.85,95%CI=(0.46,1.56),P=0.60],cystic periventricular leukomalacia[RR=1.07,95%CI=(0.66,1.75),P=0.78],severe intraventricular hemorrhage[RR=0.95,95%CI=(0.72,1.24),P=0.70],mental development index[SMD=-0.18,95%CI=(-0.67,0.31),P=0.48],psychomotor development index[SMD=-0.25,95%CI=(-0.84,0.35),P=0.42]in the test group(steroids intervention)had no statistically significant difference compared with control group(placebo).Conclusion The usage of low-dose corticosteroids for the treatment of bronchopulmonary dysplasia in very preterm or very low-weight infants had no significant adverse effects on neurodevelopment.

关 键 词：类固醇 极早产儿 极低体质量儿 神经发育 

分 类 号：R974[医药卫生—药品] R969.3[医药卫生—药学]