低分子肝素治疗胎儿生长受限的Meta分析

Effect of low molecular weight heparin in treatment of fetal growth restriction:a Meta analysis

目的系统评价低分子肝素（low molecular weight heparin,LMWH）治疗胎儿生长受限的有效性。方法自行制定检索策略：关键词定位为＂肝素治疗胎儿生长受限＂或＂The treatment effectiveness about heparin on FGR＂,采用计算机检索,在中国知网（CNKI）共检索中文文献19篇、在万方期刊数据库共检索中文文献32篇及英文Pubmed文献4篇,收集有关低分子肝素治疗胎儿生长受限方面的文献。由2位作者独立地筛选出符合要求的文献及资料提取,并采用Rev Man 5.1统计学软件分析所监测指标的加权均数差（WMD）及95%可信区间（CI）。结果按照检索策略共检索出符合纳入要求的RCTs8个,共计502例患者。Meta分析结果显示,与对照组相比,低分子肝素治疗组胎儿双顶径增长值（mm）0.90〔95%可信区间（CI）：0.78-1.02,P〈0.000 1〕;新生儿出生体重增长值（g）572.74〔95%可信区间（CI）：516.73-628.75,P〈0.000 1〕。结论与普通治疗组相比低分子肝素可以改善胎儿生长受限,使胎儿双顶径和新生儿出生体重增加。

Objective To systematically evaluate the efficacy of low molecular weight heparin（ LMWH） in treatment of fetal growth restriction（ FGR）. Methods The search strategy was formulated as follows： the key words were ＂ treatment of FGR by LMWH＂ or ＂ the treatment effectiveness about heparin on FGR＂,a computer was used to retrieve key words,19 Chinese articles were retrieved in CNKI,32 Chinese articles were retrieved in Wanfang database,4 English articles were retrieved in Pub Med,the articles about FGR treated by LMWH were collected. The articles meeting the criteria were screened out and the data was abstracted by two authors independently,Rev Man 5. 1 statistical software was used to analyze weighted mean difference（ WMD）and 95% confidence interval（ CI）. Results Eight RCTs meeting the criteria were screened out according to the search strategy,502 patients were included. The results of Meta analysis showed that compared with control group,fetal biparietal diameter in LMWH treatment group increased by 0. 90 mm（ CI： 0. 78- 1. 02,P〈 0. 000 1）,neonatal birth weight increased by 572. 74 g（ CI： 516. 73- 628. 75,P〈 0. 000 1）. Conclusion Compared with routine treatment group,LMWH can improve FGR and increase fetal biparietal diameter and neonatal birth weight.