阿司匹林联合硫酸镁治疗子痫前期临床疗效的Meta分析  

Clinical efficacy of aspirin combined with magnesium sulfate in treatment of preeclampsia:A meta⁃analysis

作　　者：李华建 朱莉娜[1] 曾洁[1] 黄运英 梁志明 罗骞[1] Li Huajian;Zhu Lina;Zeng Jie;Huang Yunying;Liang Zhiming;Luo Qian(Department of Pharmacy,Fifth Hospital Affiliated to Guangzhou Medical University,Guangzhou,510700,China;Guangzhou Medical University School of Pharmacy,Guangzhou 511436,China)

机构地区：[1]广州医科大学附属第五医院药学部,广东广州510700 [2]广州医科大学药学院,广东广州511436

出　　处：《广州医科大学学报》2022年第5期34-41,共8页Academic Journal of Guangzhou Medical University

摘　　要：目的:探索阿司匹林联合硫酸镁治疗子痫前期的临床疗效性。方法:检索中国知网、万方、维普、PubMed等数据库中自建库至2021年7月发表的关于阿司匹林联合硫酸镁治疗子痫前期的临床随机对照试验(RCT)。根据预先设定的标准排除和纳入研究文献,提取符合纳入标准的文献的数据,Review Manger5.3软件行Meta分析。结果:共纳入14项RCT研究,包括1150例子痫前期患者。Meta分析结果显示,硫酸镁联合阿司匹林治疗子痫前期患者较硫酸镁单一用药疗效好,总有效率[OR=4.34,95%CI(2.43,7.73),P<0.01]、24 h尿蛋白降低水平[OR=⁃1.59,95%CI(⁃1.97,⁃1.22),P<0.01]、肝功能损害[OR=0.23,95%CI(0.13,0.43),P<0.01]、肾功能损害[OR=0.14,95%CI(0.07,0.30),P<0.01]、新生儿窒息[OR=0.31,95%CI(0.18,0.54),P<0.01]、新生儿低体重[OR=0.21,95%CI(0.12,0.38),P<0.01]、子痫前期发病风险[OR=0.18,95%CI(0.08,0.38),P<0.01]、早产[OR=0.19,95%CI(0.10,0.35),P<0.01]等指标比较,差异均有统计学意义。结论:硫酸镁联合阿司匹林治疗子痫前期较硫酸镁单一用药能更好地防止肝肾功能损害,降低早产及子痫前期发病风险,改善尿蛋白水平,并降低围产儿不良结局发生率。Objective:To investigate the clinical efficacy of aspirin combined with magnesium sulfate in the treatment of pre⁃eclampsia.Methods:An internet search was performed for clinical randomized controlled trials(RCTs)on aspirin combined with magnesium sulfate for treatment of preeclampsia published in China Knowledge Infrastructure,Wanfang,Vip,and PubMed databases since their inception up to July 2021.The search hits were screened according to pre⁃designed criteria for exclusion and inclusion,and the studies that met inclusion criteria were extracted for data.Our meta⁃analysis was performed via Review Manger 5.3 software.Results:A total of 14 RCTs comprising 1150 patients with preeclampsia were included.The results of the meta⁃analysis showed that magnesium sulfate combined with aspirin was more effective than magnesium sulfate alone in the treatment of patients with preeclampsia,yielding significant improvement in overall treatment response rate[OR=4.34,95%CI(2.43,7.73),P<0.01],24h reduction in urine protein[OR=⁃1.59.95%CI(⁃1.97,⁃1.22),P<0.01],liver function impairment[OR=0.23,95%CI(0.13,0.43),P<0.01],renal function impairment[OR=0.14,95%CI(0.07,0.30),P<0.01],neonatal asphyxia[OR=0.31,95%CI(0.18,0.54),P<0.01],low birth⁃weight neonates[OR=0.21,95%CI(0.12,0.38),P<0.01],risk of preeclampsia[OR=0.18,95%CI(0.08,0.38),P<0.01],and preterm birth[OR=0.19,95%CI(0.10,0.35),P<0.01].Conclusion:Magnesium sulfate combined with aspirin as a treatment of preeclampsia is more favorable than magnesium sulfate alone in preventing liver and renal function impairment,lowering the risk of preterm delivery and preeclampsia,improving urine protein levels,and reducing the incidence of adverse perinatal outcomes.

关 键 词：阿司匹林 硫酸镁 随机对照实验 子痫前期 META分析 

分 类 号：R473.71[医药卫生—护理学]