先兆子痫扩容治疗的Meta分析

Plasma volume expansion for treatment of preeclampsia:a Meta analysis

目的通过Meta分析的方法评价先兆子痫扩容治疗的临床疗效。方法检索1979～2010年中外文数据库收录的公开发表与研究目的相关的随机对照试验的文献,手工检索当前能够检索到的参考资料及研究报告。制定严格的纳入与排除标准,选择原始研究并对其进行质量评价和数据提取,利用Revman5.0版软件对所纳入的研究进行Meta分析。结果共检索到符合纳入标准的5篇文献,共包括297例病人。Meta分析结果提示扩容组与非扩容组相比:①剖宫产率:2组比较差异无统计学意义(RR=1.08,95%CI:0.96～1.22,P=0.19);②早产率:扩容治疗组与对照治疗组差异无统计学意义(RR=0.91,95%CI:0.26～3.22,P=0.89)。各研究之间差异性较大;③围产儿病死率:2组比较差异无统计学意义(RR=1.65,95%CI:0.77～3.54,P=0.20);④Apgar评分<7的比率:2组比较差异无统计学意义:(RR=1.11,95%CI:0.54～2.28,P=0.77);⑤需要另外应用药物的比率2组比较差异无统计学意义:(RR=1.91,95%CI:0.90～4.05,P=0.09)。结论扩容治疗并不能改善先兆子痫孕产妇的剖宫产率、围产儿病死率和Apgar评分<7的比率以及需另外应用药物(硫酸镁及抗高血压药物)的比率。

Objective To evaluate effect of plasma volume expansion treatment for preeclampsia by Meta analysis.Methods A comprehensive literature search was performed at PubMed,Medline,Ovid,Embase,CNKI in English language for randomized controlled trials,hand search was also made to retrieve the current reference and research reports.Strict inclusion and exclusion criteria were applied to choose original research,and for quality assessment and data extraction,the software Revman 5.0 was used for the Meta analysis.Results A total of 5 reports met the inclusion criteria of,including a total of 297 patients.Meta analysis results suggest that the volume-expansion group,compared with non-expansion groups： ① had no statistically significant difference in cesarean section rate,RR = 1.08,95%CI： 0.96~1.22,P = 0.19,②the difference in the rate of premature delivery was not statistically significant between two groups,RR = 0.91,95%CI：0.26~3.22,P = 0.89.③perinatal mortality rate had no significant difference between the two groups,RR = 1.65,95%CI：0.77~3.54,P = 0.20.④the proportion of Apgar score 〈7 had no significant difference between the two groups,RR = 1.11,95%CI：0.54~2.28,P = 0.77.⑤the ratio of an additional drugs had no significant difference,RR = 1.91,95%CI：0.90~4.05,P = 0.09.Conclusion The volume expansion does not improve the treatment of preeclampsia maternal cesarean section rate,perinatal mortality,Apgar score 〈7 and the application of an additional drug（magnesium sulfate and antihypertensive drugs） ratio.