环孢素A治疗复发性流产有效性和安全性的Meta分析

Meta-analysis of efficacy and safety of cyclosporine A in the treatment of recurrent spontaneous abortion

目的通过Meta分析评价环孢素A治疗复发性流产的有效性和安全性。方法检索中国知网、维普、万方、PubMed、Cochrane、Embase数据库,收集有关环孢素A治疗复发性流产的随机对照实验(RCT),检索时限为建库至2020年10月。根据纳入标准和排除标准筛选文献、提取数据并评价纳入研究的偏倚风险,通过RevMan 5.3软件进行Meta分析,评估Meta分析结果。结果①共纳入6篇文献,包括532名复发性流产患者。②环孢素A组与对照组的妊娠成功率相对危险度(RR)为1.24,95%CI为(1.13,1.37),具有统计学差异(P<0.001)。③环孢素A组与常规治疗组妊娠期高血压发生率RR=0.22,95%CI为(0.08,0.63),差异有统计学意义(P=0.005)。结论Meta分析结果显示,环孢素A可提高妊娠成功率,并减少妊娠期高血压的发生,提示其可用于治疗复发性流产。但由于纳入文献数量有限,且样本量小,仍需进行大样本、高质量的研究进一步指导临床实践。

Objective To evaluate the efficacy and safety of cyclosporine A in the treatment of recurrent spontaneous abortion by meta-analysis.Methods The databases of CNKI,VIP,Wanfang,PubMed,Cochrane and EMBASE were searched to collect the randomized controlled trials(RCT)of cyclosporine A in the treatment of recurrent spontaneous abortion.The retrieval time was from the establishment of the database to October 2020.According to the inclusion criteria and exclusion criteria,literatures were screened,data were extracted and the risk of bias was evaluated.Meta analysis was performed by RevMan 5.3 software to evaluate the results of meta-analysis.Results①A total of 6 articles were included,including 532 patients with recurrent abortion.②The relative risk(RR)of pregnancy success rate between cyclosporine a group and conventional treatment group was 1.24,and the 95%confidence interval(CI)was 1.13,1.37,with statistical difference(P<0.001).③The incidence of pregnancy induced hypertension between cyclosporine a group and conventional treatment group was RR=0.22,95%CI=0.08,0.63,with statistical difference(P=0.005).Conclusions The results of meta-analysis show that cyclosporine A can improve the pregnancy success rate and reduce the incidence of gestational hypertension,suggesting that it can be used in the treatment of recurrent abortion.However,due to the limited number of included literatures and small sample size,it is still necessary to conduct large sample and high-quality research to further guide clinical practice.