对乙酰氨基酚治疗早产儿动脉导管未闭临床疗效的Meta分析

Efficacy of acetaminophen for the treatment of preterm infants with symptomatic patent ductus arteriosus： A meta-analysis

目的系统性评价对乙酰氨基酚治疗早产儿动脉导管未闭（patent ductus arteriosus，PDA）的疗效。方法系统检索PubMed、The CochraneLibrary、WebofScience和万方、中国知网、中国生物医学、维普数据库中对乙酰氨基酚治疗早产儿PDA的随机对照试验，检索时限均从建库截至2017年3月。由2名研究者按照纳入与排除标准独立筛选文献、提取资料并评价质量，采用RevMan5．2软件进行Meta分析。结果最终纳入8个随机对照实验，治疗组386例，对照组416例。Meta分析结果显示：治疗组的PDA闭合率与对照组相比，差异无统计学意义：MD=o．91（95％a：0．62—1．31），P=0．60；治疗组不良反应发生率较对照组降低，差异有统计学意义：MD=0．41（95％CI：0．28～0．62），P〈0．001。结论与传统非甾体消炎药物相比较，对乙酰氨基酚对早产儿PDA的治疗效果显著，且安全性良好。

Objective To systemically review the efficacy of acetaminophen for the treatment of pre- term infants with symptomatic patent ductus arteriosus（PDA）. Methods Literatures about the efficacy of acet- aminophen for the treatment of preterm infants with PDA were searched in PubMed,the Cochrane Library, Web of science, CNKI, Wanfang and VIP from the establishment of the data base until March 2017. Two researchers screened literatures according to the inclusion and exclusion criteria, extracted the data, and assessed the risk of bias independently. Then meta-analysis was performed by RevMan5. 2 software. Results There were a total of 8 randomized controlled trials（RCTs） in the meta-analysis, including 386 cases in the acetaminophen group and 416 eases in the control group. The results of meta-analysis showed that there was no significant difference in the PDA closure rate between the acetaminophen group and the control group [ mean difference（MD） =0. 91,95% confidence interval（CI） ：0. 62 - 1.31 ,P =0. 60 ]. The rate of adverse reaction in acetaminophen group was lower than the control group （MD = 0. 41,95 % CI：O. 28 -0. 62, P 〈 0. 001 ）. Conclusion Acetaminophen is effective and has lower adverse reaction compared with the traditional nonsteroidal anti-inflammatory drugs for the treatment of preterm infants with PDA.