口服阿替洛尔治疗婴幼儿血管瘤效果及安全性的单组率meta分析  

Efficacy and safety of oral atenolol for the treatment of infantile haemangiomas:a single-arm meta-analysis

作　　者：朱智胜 周仙颖 林新恭 吴诗权 王朝阳[1] 朱世泽[1] Zhu Zhisheng;Zhou Xianying;Lin Xingong;Wu Shiquan;Wang Chaoyang;Zhu Shize(Plastic Surgery Department,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院整形外科,泉州362000

出　　处：《中华整形外科杂志》2023年第11期1192-1203,共12页Chinese Journal of Plastic Surgery

摘　　要：目的探讨口服阿替洛尔治疗婴幼儿血管瘤的效果、安全性及复发率,为临床提供循证医学依据及参考。方法检索2008年1月1日至2022年6月13日Web of Science、PubMed、Cochrane Library、Embase、美国国立医学图书馆临床试验注册平台、中国知网、中国生物医学文献服务系统、中文科技期刊数据库、万方数据,根据纳入及排除标准,筛选出关于口服阿替洛尔治疗婴幼儿血管瘤的研究。结局指标为有效率(完全缓解率)、不良反应发生率和复发率。采用R软件4.1.2版进行单组率的meta分析,并对结果进行敏感性分析。采用Egger’s检验及绘制漏斗图评估文献的发表偏倚。结果最终纳入文献14篇,其中5篇随机对照试验,5篇单组研究,3篇非随机对照试验,1篇病例对照研究。口服阿替洛尔治疗婴幼儿血管瘤的有效率(完全缓解率)为62%(95%CI 52%~71%),消化系统相关不良反应发生率为18%(95%CI 7%~30%),β2受体阻断相关不良反应发生率为4%(95%CI 2%~6%),中枢神经系统相关不良反应发生率为10%(95%CI 5%~16%),复发率为5%(95%CI 2%~9%)。Egger’s检验显示,口服阿替洛尔治疗婴幼儿血管瘤的有效率、中枢神经系统相关不良反应发生率及消化系统相关不良反应发生率均无明显发表偏倚(P>0.05)。口服阿替洛尔治疗婴幼儿血管瘤的有效率、不良反应发生率及复发率敏感性的分析提示结果稳定可靠。结论口服阿替洛尔治疗婴幼儿血管瘤疗效显著、不良反应较少且复发率低,有望成为口服普萘洛尔治疗婴幼儿血管瘤的合理替代品。ObjectiveTo investigate the efficacy,safety and recurrence rate of oral atenolol in the treatment of infantile hemangioma,so as to provide evidence-based medicine basis and reference for clinic.MethodsSearch on the following public databases from January 1,2008 to June 13,2022:Web of Science,PubMed,Cochrane Library,Embase,U.S.National Library of Medicine Clinical Trials Registry Platform;China National Knowledge Infrastructure(CNKI),Chinese Biomedical Literature Service System(SinoMed),Chinese Science and Technology Journal Database and Wanfang Data.According to inclusion and exclusion criteria,studies on oral atenolol for the treatment of infantile hemangioma were selected.The outcome indicators were efficiency(complete response rate),incidence of adverse effects and recurrence rate.The single-arm meta-analysis was performed using R software version 4.1.2.Egger’s test was employed and funnel plots were drawn to assess publication bias in the literature.ResultsA total of 14 studies were included,comprising 5 randomized controlled trials,5 single-arm studies,3 non-randomized controlled trials,and 1 case-control study.The oral administration of atenolol for the treatment of infantile hemangiomas resulted in an efficacy rate(complete remission rate)of 62%(95%CI 52%~71%).The incidence rate of adverse reactions related to the digestive system was 18%(95%CI 7%~30%),while that related toβ2 receptor blockade was 4%(95%CI 2%~6%),central nervous system-related adverse reactions occurred at a rate of 10%(95%CI 5%~16%),the recurrence rate was 5%(95%CI 2%~9%).Egger’s test indicated that there was no significant publication bias in the efficacy rate,central nervous system-related adverse reaction rate,and gastrointestinal-related adverse reaction rate of oral atenolol treatment for infantile hemangiomas(P>0.05).The sensitivity analysis for the efficacy rate,adverse reaction rate,and recurrence rate of oral atenolol treatment for infantile hemangiomas suggested that the result were stable and reliable.ConclusionOral admini

关 键 词：血管瘤 Β受体阻断剂 普萘洛尔 阿替洛尔 META分析 

分 类 号：R732.2[医药卫生—肿瘤]