血管扩张剂治疗新生儿持续性肺动脉高压有效性和安全性的网状Meta分析  

Network Meta-Analysis on Efficacy and Safety of Vasodilators in the Treatment of Persistent Pulmonary Hypertension of Newborn

作　　者：吴迪[1] 叶停停 包蕾[1] Wu Di;Ye Tingting;Bao Lei(Children’s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Structural Birth Defect and Reconstruction,Chongqing 400014,China;Guizhou Tongren Maternity and Child Health Care Hospital,Guizhou Tongren 554300,China)

机构地区：[1]重庆医科大学附属儿童医院,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,结构性出生缺陷与器官修复重建重庆市重点实验室,重庆400014 [2]铜仁市妇幼保健院,贵州铜仁554300

出　　处：《儿科药学杂志》2024年第9期28-35,共8页Journal of Pediatric Pharmacy

摘　　要：目的:通过网状Meta分析方法探讨不同种类的血管扩张剂在治疗新生儿持续性肺动脉高压(PPHN)的有效性和安全性。方法:检索PubMed、EMBase、the Cochrane Library、Web of Science、中国生物医学文献数据库、中国知网、万方、维普数据库中有关血管扩张剂治疗PPHN的文献,检索时限均为建库至2023年6月20日。通过NoteExpress 3.9软件进行文献管理,利用Stata 17.0软件对不同血管扩张剂治疗PPHN的有效性和安全性进行网状Meta分析。结果:最终纳入47篇文献,包含5类药物组成的10种治疗方案。Meta分析结果显示,各治疗方案在各种结局中的有效性排名不一致,磷酸二酯酶-5抑制剂(PDE5i)+吸入性一氧化氮(iNO)、前列腺素类似物和前列环素受体激动剂(PRA)整体评价较好;安全性方面,未观察到血管扩张剂的严重不良反应。结论:选用血管扩张剂在治疗PPHN时,PDE5i+iNO组合可能是最优选择,但当iNO不可用时,可选西地那非;由于本研究的局限性,结论尚需更多临床随机对照试验证实。Objective:To probe into the efficacy and safety of different types of vasodilators in the treatment of persistent pulmonary hypertension of newborn(PPHN)through network Meta-analysis.Methods:PubMed,EMBase,the Cochrane Library,Web of Science,CBM,CNKI,Wanfang,and VIP databases were retrieved to collect literature related to vasodilators in the treatment of PPHN.The retrieval time was from the establishment of the database to Jun.20th,2023.NoteExpress 3.9 software was used for literature management,and Stata 17.0 software was used to perform network Meta-analysis on efficacy and safety of different vasodilators in the treatment of PPHN.Results:A total of 47 articles were enrolled,including 10 treatment regimens with 5 classes of drugs.Meta-analysis showed inconsistent ranking results of each treatment regimen in various outcomes.The combination of phosphodiesterase type 5 inhibitor(PDE5i)+inhaled nitric oxide(iNO),prostaglandin analogs and prostanoid analogues(PRA)had better overall evaluations.Regarding safety,no severe adverse drug reactions of vasodilators were observed.Conclusion:PDE5i+iNO may be the optimal selection in the treatment of PPHN,yet sildenafil may be the most hopeful option in the treatment of PPHN when iNO is unavailable.However,due to certain limitations,more clinical randomized controlled trials are needed in the future for further confirmation.

关 键 词：新生儿持续性肺动脉高压 血管扩张剂 网状Meta分析 

分 类 号：R722.1[医药卫生—儿科]