妊娠期使用阿司匹林预防子痫前期的临床实践指南评价  

Evaluation on Clinical Practice Guidelines for Application of Aspirin in Preventing Preeclampsia During Pregnancy

作　　者：张颖[1] 徐曼 杜博冉[1] 王然[1] 冯欣[1] ZHANG Ying;XU Man;DU Boran;WANG Ran;FENG Xin(Dept.of Pharmacy,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院药事部,北京100026

出　　处：《中国医院用药评价与分析》2024年第8期897-900,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金青年项目(No.72204170);北京市医院管理中心临床医学专项经费资助(No.ZYLX202119);广东省药品不良反应监测中心委托业务(委31);北京市属医院科研培育项目(No.PZ2021028);中国药学会医院药学专业委员会医院药学科研专项资助项目(No.CPA-Z05-ZC-2022-002);北京药学会临床药学研究项目(No.LCYX-2022-06);北京药理学会智慧药学专项(No.320.6750.2020-08-48)。

摘　　要：目的:探讨国内外妊娠期使用阿司匹林预防子痫前期相关临床实践指南的质量情况。方法:系统检索2012—2023年发布的妊娠期使用阿司匹林预防子痫前期相关临床实践指南,使用指南研究和评估工具Ⅱ(AGREEⅡ)对纳入指南的质量进行评价分析,并对各指南中的主要推荐内容进行比较和总结。结果:共纳入18部妊娠期使用阿司匹林预防子痫前期相关临床实践指南,其中4部为A级推荐,13部为B级推荐,1部为C级推荐。基于AGREEⅡ的整体指南评价结果显示,在范围和目的、参与人员、严谨性、清晰性、应用性、独立性各领域的平均得分分别为62.96%、60.03%、62.21%、96.14%、43.06%、66.20%。目前,各国指南均推荐具有一定子痫前期风险的妊娠期妇女预防性应用阿司匹林,但对阿司匹林疗程和剂量的推荐具有差异。结论:近10年全球发布的有关阿司匹林预防子痫前期的指南中,中等质量、高质量的指南相对较多,主要的不足集中在应用性领域,以及目标人群观点、证据选择标准和外审专家的参与等项目,需要指南开发者进一步改进。OBJECTIVE:To explore the quality of clinical practice guidelines related to application of aspirin in preventing preeclampsia during pregnancy at home and abroad.METHODS:Clinical practice guidelines related to application of aspirin in preventing preeclampsia during pregnancy published from 2012 to 2023 were systematically retrieved,the Appraisal of Guidelines for Research and EvaluationⅡ(AGREEⅡ)were used to perform evaluation and analysis on the quality of enrolled guidelines,and to conduct comparison and summary on the main recommendations in each guidelines.RESULTS:A total of 18 clinical practice guidelines related to application of aspirin in preventing preeclampsia during pregnancy were enrolled,4 of which were A-level recommendation,13 were B-level recommendation and 1 was C-level recommendation.Results of general guideline evaluation based on AGREEⅡindicated that the average scores were respectively 62.96%,60.03%,62.21%,96.14%,43.06%,66.20%in the fields of range and purpose,participants,preciseness,explicitness,applicability,independence.Currently,the preventive application of aspirin for pregnant women with certain risk of preeclampsia were recommended in guidelines of various countries,while there were differences in the recommended treatment course and dosage of aspirin.CONCLUSIONS:Among the guidelines on aspirin for the prevention of preeclampsia published globally in the last 10 years,there are a relatively large number of moderate-quality and high-quality guidelines,with the main shortcomings centered in the applicability filed,as well as in items such as target population perspectives,selection criteria of evidence and involvement of external reviewers,which require further improvement by guideline developers.

关 键 词：阿司匹林 子痫前期 预防 指南研究和评估工具Ⅱ 指南评价 

分 类 号：R973.2[医药卫生—药品]