腺苷蛋氨酸联合蓝光治疗新生儿高胆红素血症的Meta分析  

A Meta-analysis of S-adenosyl-L-methionine Combined With Blue Light in the Treatment of Neonatal Hyperbilirubinemia

作　　者：高阳 张蕾 孔祥斌 郭英萌 GAO Yang;ZHANG Lei;KONG Xiangbin;GUO Yingmeng(Department of Neonatal Intensive Care Unit,Linyi Central Hospital,Linyi Shandong 276400,China;Department of Ultrasound,Yishui Maternal and Child Health Service Center,Yishui Shandong 276400,China;Department of Otolaryngology,Linyi Central Hospital,Linyi Shandong 276400,China)

机构地区：[1]临沂市中心医院新生儿重症监护室,山东临沂276400 [2]沂水县妇幼保健计划生育服务中心超声科,山东沂水276400 [3]临沂市中心医院耳鼻咽喉科,山东临沂276400

出　　处：《中国卫生标准管理》2022年第19期18-23,共6页China Health Standard Management

摘　　要：目的系统评价腺苷蛋氨酸(S-adenosyl-L-methionine,S-Ame)联合蓝光治疗新生儿高胆红素血症的疗效。方法计算机检索Pubmed、Cochrane、Embase、Web ofScience、Clinical trials、中国期刊全文数据库(China national knowledge infrastructure,CNKI)、中国生物医学文献数据库(China Biology Medicine disc,CBMdisc)、万方数据库中关于S-Ame联合蓝光治疗新生儿高胆红素血症的临床随机对照研究,检索时间自建库至2022年5月。由两名研究者按照纳入与排除标准独立筛选文献、提取数据、进行质量评价并交叉核对,采用RevMan 5.4软件进行Meta分析。结果共纳入6篇文献,共581例患儿,其中试验组(S-Ame联合蓝光治疗组)321例患儿,对照组(蓝光治疗组)260例患儿。Meta分析结果显示,S-Ame联合蓝光治疗较蓝光治疗可明显降低3 d(MD=-31.99,95%CI:-51.91~-12.07,P=0.002)、7 d(MD=-35.56,95CI:-53.35~-17.76,P<0.0001)总胆红素水平,明显缩短住院时间(MD=-0.90,95%CI:-1.47~-0.33,P=0.002),差异均有统计学意义(P<0.05);治疗总有效率高于蓝光治疗组(RR=1.25,95%CI:0.98~1.59,P=0.08),但差异无统计学意义(P>0.05)。结论S-Ame联合蓝光治疗可有效降低新生儿高胆红素血症患儿的血清胆红素浓度,缩短黄疸持续时间。Objective To systematically evaluate the efficacy of S-adenosyl-L-methionine(S-Ame)combined with phototherapy on neonatal hyperbilirubinemia.Methods From establishment of the databases to May 2022,clinical randomized controlled trials of S-Ame combined with phototherapy on neonatal hyperbilirubinemia were searched on English databases(Pubmed,Cochrane,Embase,Web of Science,Clinical trials)and Chinese databases[China national knowledge infrastructure(CNKI),China Biology Medicine disc(CBMdisc),Wanfang].Two researchers independently screened the literature according to the inclusion and exclusion criteria,extracted the data,evaluated the quality and cross-checked.RevMan 5.4 software was used for Metaanalysis.Results Six randomized controlled studies with a total of 581neonates were included,including 321 cases in experimental group(S-Ame combined with phototherapy)and 260 cases in the control group(phototherapy).Meta-analysis results showed that the total bilirubin level in the experimental group was significantly reduced at 3rd days(MD=-31.99,95%CI:-51.91 to-12.07,P=0.002)and 7th days(MD=-35.56,95CI:-53.35 to-17.76,P0.05).Conclusion S-adenosyl-L-methionine combined with blue light therapy can effectively reduce the serum bilirubin concentration and shorten the duration of jaundice in neonatal hyperbilirubinemia.

关 键 词：腺苷蛋氨酸 蓝光治疗 高胆红素血症 新生儿 系统评价 META分析 随机对照试验 

分 类 号：R722[医药卫生—儿科]