盐酸利托君与硫酸镁治疗先兆早产疗效比较的系统评价

Ritodrine Hydrochloride versus Magnesium Sulfate for Threatened Premature Labor: A Systematic Review

目的比较盐酸利托君与硫酸镁治疗先兆早产的临床疗效及其临床价值。方法计算机检索PubMed、Cochrane图书馆、CNKI、万方数据库、维普数据库,并追查了所有纳入文献的参考文献,检索年限均从建库截止至2010年2月,收集盐酸利托君与硫酸镁治疗先兆早产的随机对照试验,按Cochrane系统评价的方法评价纳入研究质量,对同质研究采用Cochrane协作网提供的RevMan4.2进行Meta分析,对数据不能合并者,进行描述性的定性分析。结果本研究共纳入9个随机对照试验,包括591例患者,其中应用盐酸利托君治疗者308例,应用硫酸镁治疗者283例。Meta分析结果显示,盐酸利托君组与硫酸镁组相比,显效时间明显缩短,加权均数差=-2.97,95%可信区间(-4.18,-1.77);延长孕周时间明显,加权均数差=8.58,95%可信区间(5.76,11.40);新生儿体重明显增加,加权均数差=0.36,95%可信区间(0.28,0.43);新生儿窒息发生率相等,风险差异=-0.06,95%可信区间(-0.14,0.02)。结论基于当前证据,盐酸利托君治疗先兆早产的显效时间、延长孕周时间及新生儿出生体重均优于硫酸镁,新生儿窒息情况两者相等,两者不良反应的比较尚需进一步的研究证实。

Objective To compare and evaluate the effectiveness and the clinic value between Ritodrine hydrochloride and Magnesium sulfate in the treatment of threatened premature labor. Methods We searched PubMed, Cochrane Library, CNKI, Wanfang, VIP, and references of the included studies up to February 2010. Studies involving treatment outcome of threatened premature labor using Ritodrine hydrochloride compared with Magnesium sulfate were included. Data were extracted and methodological quality was evaluated by two reviewers independently with designed extraction form. The Cochrane Collaboration＇s RevMan 4.2 software was used for data analyses. Results A total of 9 studies involving 591 patients were included （Ritodrine hydrochloride, 308; Magnesium sulfate, 283）. The results of meta-analyses showed that Ritodrine hydrochloride comparing with Magnesium sulfate significantly more effective in the controlling of the uterine contraetion,WMD=-2.97,95% CI （-4.18,-1.77）; more effective in the prolongation of gestational age, WMD=8.58, 95%CI（5.76, 11.40）; more effective in the weights of the newborns, WMD =0.36,95% CI （0.28,0.43） ; equal in asphyxia of newborn, RD =-0.06, 95% CI （-0.14,0.02）. Conclusion Ritodrine hydrochloride treating for threatened premature labor is better than Magnesium sulfate in the treating period of suppression of contraction, prolongation of gestation for days and birth weights of newborns, asphyxia of newborn are equal in the both. But more attention should be paid to the untoward reaction.