熊去氧胆酸联合蓝光治疗新生儿高胆红素血症疗效的Meta分析

Meta-analysis of the Efficacy of Ursodeoxycholic Acid Combined with Blue Light in the Treatment of Neonatal Hyperbilirubinemia

目的系统评价熊去氧胆酸(UDCA)联合蓝光对新生儿高胆红素血症的治疗效果。方法检索PubMed、EMbase、Web of Science、Cochrane图书馆、中国期刊全文数据库(CNKI)、万方数据库(Wanfang)和中国国生物医学文献数据库(SinoMed)有关熊去氧胆酸联合蓝光治疗新生儿高胆红素血症的临床随机对照研究,检索时间自建库至2021年2月。对符合标准的研究进行质量评价,并应用RevMan5.4软件进行Meta分析。结果共纳入随机对照研究4篇,共400例新生儿,其中熊去氧胆酸组198例,对照组202例。Meta分析结果显示,熊去氧胆酸组治疗12 h(MD=-2.37,95%CI:-3.10~-1.64)、24 h(MD=-2.95,95%CI:-3.88~-2.02)总胆红素值低于对照组,差异有统计学意义(P<0.00001);熊去氧胆酸组治疗48 h总胆红素低于对照组(MD=-2.46,95%CI:-4.98~0.06),但差异无统计学意义(P>0.05);熊去氧胆酸组总光疗时长短于对照组(SMD=-2.70,95%CI:-3.01~-2.40),差异有统计学意义(P<0.00001)。结论熊去氧胆酸联合蓝光治疗对于新生儿高胆红素血症患儿具有较好的疗效,但该结论仍需大量多中心的随机对照研究进一步证实。

Objective To systematically evaluate the therapeutic effect of ursodeoxycholic acid(UDCA)combined with blue light on neonatal hyperbilirubinemia.Methods PubMed,EMbase,Web of Science,Cochrane Library,Chinese Journal Full-text Database(CNKI),Wanfang Database and Chinese Biomedical Literature Database(SinoMed)were searched for clinical randomized controlled studies on ursodeoxycholic acid combined with blue light in the treatment of neonatal hyperbilirubinemia.The retrieval time was from the establishment of the database to February 2021.The quality of the studies that met the criteria was evaluated,and meta-analysis was performed using RevMan 5.4 software.Results A total of 4 randomized controlled studies were included,with a total of 400 newborns,including 198 newborns in the ursodeoxycholic acid group and 202 newborns in the control group.The results of Meta-analysis showed that the total bilirubin value of 12 h(MD=-2.37,95%CI:-3.10 to-1.64)and 24 h(MD=-2.95,95%CI:-3.88 to-2.02)in the ursodeoxycholic acid group was lower than that in the control group,and the difference was statistically significant(P<0.00001);the total bilirubin in the ursodeoxycholic acid group was lower than that in the control group at 48 h(MD=-2.46,95%CI:-4.98 to 0.06),but the difference was not statistically significant(P>0.05);the total duration of phototherapy in the ursodeoxycholic acid group was shorter than that in the control group(SMD=-2.70,95%CI:-3.01 to-2.40),and the difference was statistically significant(P<0.00001).Conclusion Ursodeoxycholic acid combined with blue light therapy has a good effect on neonatal hyperbilirubinemia,but this conclusion still needs to be further confirmed by a large number of multi-center randomized controlled studies.