神经节苷脂治疗新生儿缺氧缺血性脑病的Meta 分析

摘要

目的：评价神经节苷脂治疗新生儿缺氧缺血性脑病( HIE)的疗效、安全性及预后。方法制定原始文献纳入、排除标准及检索策略,检索Cochrane图书馆、PubMed、EMBASE、CBM、CNKI、万方数据库及维普中文科技期刊数据库等,获得神经节苷脂治疗HIE的随机对照试验。应用 Cochrane协作网推荐的方法评价文献质量,采用 RevMan4．22软件对满足纳入标准的神经节苷脂治疗HIE的RCT文献进行Meta分析。结果共纳入12个RCT,包括HIE患者1075例。Meta分析结果显示：与对照组比较,治疗后头颅CT正常率增加(OR=3．09,95%CI：1．91~5．01),生后10~14d NBNA评分明显改善(WMD=2．55,95%CI ：2．18~2．92)；后遗症的发生率也明显减少(OR=0．27,95%CI：0．11~0．66)。结论在HIE常规治疗基础上加用神经节苷脂可改善生后10~14d NBNA评分,提高头颅CT正常率,有效改善预后,减少后遗症的发生。%Objective To assess the effectiveness, safety and prognosis of ganglioside in the treatment of hypoxic ische-mic encephalopathy. Methods The randomized controlled trials ( RCTs) on ganglioside for HIE were reviewed in the following e-lectronic databases :the Cochrane library, PubMed, Embase, CBM, CNKI, VIP, WangFang. Standard methods of the Cochrane Collaborati on and its Neonatal Group were used to assess the methodological quality of the trials. Rev Man 4. 22 soft ware was used to make meta analysis. Results Eithteen randomized controlled trials involving 1275 infants with moderate/severe encephaiopathy were included. Meta-analyses showed that, compared with the control group, the effective rate was higher in the treatment group (OR= 3. 96;95%CI:2. 39 ~6. 55), the normality rate of brain CT increased(OR=3. 09, 95%CI:1. 91 ~5. 01), the NBNA mark was improved 10-14 days after birth(WMD= 2. 55, 95%CI :2. 18~2. 92), and with lower occurrence rate of sequelae of nerve system(OR=0. 27, 95%CI:0. 11~0. 66). Conclusion Ganglioside combined with conventional therapy in HIE is more ef-fective, the NBNA score was higher 10~14 days after birth, the normality rate of brain CT was increased, the sequelae occurring rate was decreased, and with a better prognosis.