神经节苷脂治疗新生儿缺氧缺血性脑病的系统性评价

Systematic Evaluation of Neonatal Hypoxic Ischemic Encephalopathy Treated with Ganglioside

目的:评价神经节苷脂治疗新生儿缺氧缺血性脑病的临床疗效和安全性。方法:检索1985年6月1日至2015年6月30日Pub Med、Science Direct、LISTA、中国期刊全文数据库、中国生物医学文献数据库、万方数字化全文期刊数据库,确定纳入标准和排除标准,检索相关文献,对其进行质量评价,应用Rev Man5.0软件进行Meta分析。结果:共纳入14篇文献,Meta分析结果显示:(1)观察组的头颅CT异常发生率较对照组低[RR=0.49,95%CI(0.30,0.81),Z=0.81,P<0.01];(2)观察组缺氧缺血性脑病新生儿神经行为测定(NBNA)评分的干预作用优于对照组[MD=1.31,95%CI(1.02,1.60),Z=8.94,P<0.01];(3)观察组的神经系统后遗症发生率较对照组低[RR=0.35,95%CI(0.15,0.82),Z=0.81,P<0.01]。结论:与单纯常规治疗相比,神经节苷脂能够降低头颅CT异常发生率、改善神经行为评分、减少神经系统后遗症的发生,但需要更多大样本、多中心、高质量的随机对照双盲试验进一步验证。

Objective： To evaluate the efficacy and safety of ganglioside in the treatment of neonates with hypoxic-ischemic encephalopathy（ HIE）. Methods： Search the Pub Med,Science Direct,LISTA,China journal-full text database,Chinese biomedical literature database,digital full-test journals database,then include or exclude the studies according the selected criteria. Searched the related trials,assessed the methodological quality,the Meta-analysis was performed using Rev Man5.0 software. Results： Fourteen trials were included,Meta-analysis results showed：（ 1） The incidence of abnormal CT of observation group was statistically lower than that of control group [RR = 0.49,95% CI（ 0.30,0.81）,Z = 0.81,P〈0.01].（ 2） The score of NBNA of observation group was statistically higher than that of control group [MD = 1.31,95% CI（ 1.02,1.60）,Z = 8.94,P〈0.01].（ 3） The incidence of neurological sequelae of observation group were statistically lower than that of control group [RR = 0. 35,95% CI（ 0. 15,0. 82）,Z = 0. 81,P〈0. 01].Conclusion： Compared with the control group,ganglioside can effectively reduce the head CT abnormality rate,improve the neurological score,reduce the incidence of neurological sequelae, but need more large sample, the high quality, double-blind multicenter randomized controlled trial for the further verification.