氢化可的松治疗早产儿低血压疗效的Meta分析

Hydrocortisone for treating hypotension in preterm infants :A meta-analysis

目的：讨论氢化可的松在治疗早产儿低血压和减少肌力调节药物使用剂量、降低其不良反应方面的意义。方法：检索Cochrane图书馆、PubMed、Ovid、Springer等数据库中的文献,制订文献纳入及排除标准,并通过查阅文献制订疗效判断标准。按照纳入标准选择文献,采用随机和固定效应模型等标准的Meta分析方法来进行数据分析,采用SPSS13.0统计软件进行统计学处理,合并相关效应值和显著水平。结果：根据纳入标准,有7个研究,共144例早产儿入选,分为氢化可的松治疗组（n=144）和多巴胺＋氢化可的松治疗组（n=93）,随机效应Meta分析显示氢化可的松能有效升高血压（r=0.74,95%CI：0.16~0.91）且能够减少肌力调节药物（Inotrope）的用量（r=0.72,95%CI：0.0124~0.96）。结论：氢化可的松能够有效治疗早产儿低血压,减少肌力调节药物的使用量且未见明显的短期不良反应,但其长期安全性仍需要进一步研究。

Objective：To discuss the efficacy of hydrocortisone for treating hypotension and reduction of vasopressor requirements in preterm infants. Methods：A search in Cochrane Library,PubMed,Ovid,Springer was performed to identify relevant articles according to the inclusion criteria. Standard meta-analytic techniques,including random and fixed effects models,were used to calculate combined effect size correlations and significance levels. Results：Seven studies were included,with total 144 newborns,144 cases in Hydrocortisone group and 93 cases in Hydrocortisone and inotrope group. Random effects meta-analysis showed that hydrocortisone increases blood pressure（r = 0.74,95%CI：0.16 to 0.91） and reduces vasopressor requirement（r = 0.72,95%CI： 0.0124 to 0.96）. Conclusion：Hydrocortisone is effective in treatment of refractory hypotension and decreasing vasopressor requirements in preterm without an increase in short term adverse consequences. However,the long term safety data on the use of hydrocortisone is unknown.