催产素受体拮抗剂atosiban和β-受体激动剂治疗早产疗效比较的Meta分析

The oxytocin antagonist atosiban versus the β-agonist in the treatment of preterm labor:a Meta analysis

目的：系统评价催产素受体拮抗剂atosiban（阿托西班）和β-受体激动剂治疗早产的效果和安全性。方法：检索1995年1月至2013年1月Medline医学数据库、SDOS全文数据库等公开发表的应用atosiban和B．受体激动剂治疗早产的随机对照实验（RCT）的全部文献，用Review Manager4．2软件对实验数据进行合并分析。结果：最终纳入5篇文献。Meta分析结果显示，atosiban组孕妇对药物不良反应的发生率显著低于β-受体激动剂组（P〈0．05）；两组治疗早产的效果无显著差异（48h未分娩：OR=0．89，95％叫为0．59～1．35，P〉0．05；7天未分娩：OR=1．10，95％凹为0．79～1．53，P〉0．05）。atosiban组孕妇对药物48h有效耐受的比例高于B-受体激动剂组，但无显著差异（OR=1．28，95％CI为0．95～1．73，P〉0．05）；而对药物7天有效耐受的比例显著高于β-受体激动剂组（OR=1．76，95％CI为1．34～2．31，P〈0．05）。Atosiban组新生儿未转NICU和新生儿转入NICU后住院小于1周的发生率低于B一受体激动剂组，但无显著差异（新生儿未转NICU：OR=0．89，95％CI为0．67～1．17，新生儿转入NICU后住院小于l周：OR=1．58，95％c，为0．98～2．55）（95％a包含1或WMD包含0）；两组的新生儿发病率基本相似，无显著差异。结论：Atosiban治疗早产的疗效与β-受体激动剂无显著差异，但安全性更优越。

Objective：To evaluate the effecacy and safety of atosiban and β-agonist therapy on women with preterm labor. Methods： Medline, SDOS, and some other databases were searched for randomized trails on atosiban and β-agonist therapy on women with preterrn labor from Jan. 1995 to Jan. 2013. With the Review Manager 4.2 software combined analysis of the experimental data in the literature five literatures were analyzed by Review Manger 4.2 soft- ware. Results：Eventually incorporated into five literatures. Meta analysis showed, atosiban group of maternal morbidity was significantly lower than β-agonist group （ P 〈 0.05 ）. Two groups of clinical effectiveness had no significant differences （ undelivered after 48 hours ： OR = 0.89, 95 % CI O. 59 - 1.35, P〉0.05 ; undelivered after 7 days ： OR = 1.10,95 % CI O. 79 - 1.53, P〉 0.05 ）. Atosiban group, the proportion of women not requiring alternative tocolytic therapy within 48h of treatment,was higher than 13-agonist group, but there was no significant difference （ OR = 1.28,95 % CI O. 95 - 1.73, P〉0.05 ）. The proportion of women not requiring alternative tocolytic therapy within 7 days of treatment in atosiban group was significantly higher than the proportion of the 13-agonist group（ OR = 1.76,95% CI 1.34 - 2.31, P〈0.05 ）. Atosiban group of neonatal not turned in NICU and newborn into the incidence of hospitalization was less than 1 week after NICU below 13-agonist group, but there was no significant difference （neonatal not turned in NICU： OR ： 0.89,95% CI O. 67 ~ 1.17, newborn into the incidence of hospitalization is less than l week after NICU ： OR = 1.58,95% CI O. 98 - 2.55） （ OR 95% CI include 1 or IVMD 95 % CI include 0）. There was no significant difference of the neonatal morbidity between the two groups. Conclusions：Atosiban is comparable in clinical effectiveness to conventional 13- 812agonist therapy is safer than β-agonist.