硫酸镁对比安慰剂治疗子痫前期疗效与安全性的Meta分析

Meta-analysis comparing the efficacy and safety of magnesium sulfate with placebo in preeclampsia

目的 系统评价比较硫酸镁和安慰剂治疗子痫前期的效果。方法 制定严格的纳入和排除标准。检索Pubmed、EMBASE、中国知网和万方数据库。由两位研究者独立对符合纳入标准的随机对照试验进行质量评价和资料提取,并进行交叉核对。采用母体指标和新生儿指标。统计学处理采用Review Manager 5.0软件。结果 本循证医学分析共纳入5篇研究,研究质量均较高(JADA 4~5分)。结果显示,与安慰剂组相比,硫酸镁组发生子痫(RR=0.43,95%CI:0.30~0.61)例数更少,差异有统计学意义(P <0.000 01)。两组患者母体死亡例数差异无统计学意义(RR=0.55,95%CI:0.26~1.15,P=0.11);两组发生胎儿/新生儿死亡例数差异无统计学意义(RR=1.02,95%CI:0.90~1.15,P=0.80)。结论 硫酸镁治疗子痫前期可有效减少子痫的发生,效果确切。

Objective Compare effect of magnesium sulfate with placebo in preeclampsia.Methods Establishing strict inclusion and exclusion criteria.Retrieve data from Pubmed,EMBASE,CNKI,and Wanfang datebase.Two researchers assessed the quality of included randomized controlled trials and extracted data independently.The following outcomes were assessed:maternal outcome and neonatal outcome.The EBM-analysis was performed using Review Manager 5.0 software.Results We included 5 RCTs.All studies were high quality with JADA score 4~5.Compared with placebo group,magnesium sulfate group showed less eclampsia(RR=0.43,95%CI:0.30~0.61),with statisticaliy significant difference(P<0.00001).There was no statistically significant difference in the number of maternal deaths between the two groups of patients(RR=0.55,95%CI : 0.26 ~ 1.15, P = 0.11). There was also no statistically significant difference in the number of fetal/neonatal deaths between the two groups (RR = 1.02, 95% CI : 0.90 ~ 1.15, P = 0.80). Conclusion Magnesium sulfate treatment for preeclampsia can effectively reduce the occurrence of eclampsia with a definite effect.