硫酸镁联合拉贝洛尔对妊娠期高血压的疗效及妊娠结局的Meta分析

Efficacy of magnesium sulfate combined with labetalol for treatment of gestational hypertension and its effects on pregnancy outcome: a meta-analysis

目的:系统评价硫酸镁联合拉贝洛尔治疗妊娠期高血压的疗效、安全性以及对妊娠结局的影响。方法:依据纳入和排除标准在PubMed、中国知网、维普科技期刊数据库以及万方医学网,检索硫酸镁联合拉贝洛尔治疗妊娠期高血压的随机对照试验的文献,使用Jadad评价标准进行质量评价,并通过RevMan5.3和Stata11.0软件对纳入研究进行Meta分析。结果:共纳入23篇文献,包括硫酸镁联合拉贝洛尔治疗的试验组患者1371例,单用硫酸镁治疗的对照组患者1360例。Meta分析结果显示,与对照组相比,试验组的总有效率更高(OR=4.68,95%CI:3.24~6.76,P<0.01),降低心率效果更好(MD=-4.80,95%CI:-6.37^-3.23,P<0.01),不良反应发生率更低(OR=0.59,95%CI:0.42~0.85,P=0.004),产后出血(OR=0.30)、子宫损伤(OR=0.19)、新生儿窒息(OR=0.23)以及胎儿窘迫(OR=0.26)等妊娠结局情况更好。结论:硫酸镁联合拉贝洛尔比单一使用硫酸镁治疗妊娠期高血压的疗效、安全性及妊娠结局更好。

Objective: To systematically evaluate the efficacy of magnesium sulfate combined with labetalol in the treatment of gestational hypertension and its effects on pregnancy outcome. Methods: According to the inclusion and exclusion criteria, the related literatures about the treatment of gestational hypertension by magnesium sulfate combined with labetalol were searched in PubMed, CNKI, VIP and Wanfang databases. The meta-analysis was performed by using RevMan 5.3 and Stata 11.0 softwares. Results: A total of 23 randomized controlled trials with 1 371 cases in the experimental group and 1 360 cases in the control group were included in this meta-analysis. The results showed that compared with the control group, the total effective rate of the experimental group was higher (OR=4.68, 95% CI: 3.24-6.76, P<0.01), the heart rate was better (MD=- 4.80, 95%CI:- 6.37 -- 3.23, P<0.01), the incidence of adverse reactions was lower (OR=0.59, 95%CI: 0.42-0.85, P=0.004), and the pregnancy outcomes such as postpartum hemorrhage (OR=0.30), uterine injury (OR=0.19), neonatal asphyxia (OR=0.23), and fetal distress (OR=0.26) were better. Conclusion: Magnesium sulfate combined with labetalol has better efficacy and good pregnancy outcomes in the treatment of gestational hypertension compared with magnesium sulfate alone.