褪黑素治疗新生儿缺氧缺血性脑病有效性的系统评价和Meta分析
Efficacy of melatonin therapy for neonatal hypoxic-ischemic encephalopathy:systematic review and meta-analysis
张超 1阴怀清 1阴崇娟 1张文龙 1钟亚婧 1师睿1
作者信息
- 1. 山西医科大学第一临床医学院,山西医科大学第一医院儿科,太原 030001
- 折叠
摘要
目的 系统评价褪黑素治疗新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)的临床疗效.方法 计算机检索PubMed、Web of Science、Cochrane library、Embase、中华医学期刊全文数据库、中国知网、万方数据库、维普数据库自建库至2022年12月1日收录的以褪黑素作为干预手段治疗HIE的国内及国外公开发表的临床随机对照试验(randomized controlled trial,RCT)和队列研究.应用R4.2.2软件和RevMan5.4软件进行Meta分析、文献风险评估以及敏感性分析.结果 共纳入有效RCT4项,患儿155例.Meta分析结果显示,应用褪黑素可以降低HIE患儿病死率(RR=0.336,95％CI0.157～0.718,P=0.005),应用褪黑素后 HIE 患儿血白细胞计数降低(MD=-1.741,95％CI-3.404～-0.079,P=0.040).敏感性分析结果显示,逐一剔除各项研究后,Meta分析结果基本稳定.结论 现有研究证据表明,褪黑素治疗可降低HIE患儿病死率,但因纳入研究的风险偏倚较大,样本量偏小,仍需更多高质量的研究作为循证依据.
Abstract
Objective To systematically evaluate the clinical efficacy of melatonin for neonatal hypoxic-ischemic encephalopathy(HIE).Methods From the inception of the databases to December 1,2022,randomized controlled trials(RCTs)and cohort studies on the use of melatonin for HIE were searched in the following databases:PubMed,Web of Science,Cochrane library,Embase,Chinese Medical Journal Full-text Database,CNKI,Wanfang Database and VIP Database.Meta-analysis,literature risk assessment and sensitivity analysis were conducted using R4.2.2 software and RevMan5.4 software.Results A total of 4 eligible RCTs were found,including 155 patients.Meta-analysis showed that melatonin could reduce the mortality rate(RR=0.336,95％CI 0.157-0.718,P=0.005)and white blood cell count in HIE infants(MD=-1.74,95％CI-3.404--0.079,P=0.040).Sensitivity analysis showed that the Meta-analysis results were generally stable after excluding the studies one by one.Conclusions Current evidence shows that melatonin can reduce mortality in HIE infants.However,the included studies have high risk of bias and small sample sizes.More high-quality studies are still needed.
关键词
缺氧缺血性脑病/褪黑素/新生儿/Meta分析/治疗Key words
Hypoxic-ischemic encephalopathy/Melatonin/Neonate/Meta-analysis/Therapy引用本文复制引用
出版年
2024
NETL
NSTL
万方数据