目的 評價沙丁胺醇治療孕婦早產的療效與安全性。
方法 計算機檢索MEDLINE(1966~2007.1)、EMbase(1966~2007.1)、Cochrane對照試驗資料庫(2006年第4期)、CBMdisc(1978~2007.1)和CNKI(1979~2007.1),收集沙丁胺醇治療早產的隨機和半隨機試驗,對符合納入標準的臨床研究進行Meta分析。
結果 共納入19篇隨機和半隨機試驗,其中中文16篇,英文3篇。未檢索到關于此題目的其他語種研究報告。16項中文研究的Jadad改良法評分均 lt;3分,為低質量文獻,各研究均未描述具體的隨機方法,未進行分配方案的隱藏,未使用盲法,未對遠期效果進行評價。3篇英文研究的Jadad改良法評分 gt;5分,對遠期效果進行了評價,為高質量文獻。與基礎治療相比,沙丁胺醇組保胎超過48 h的人數較高[RR(95%CI)為6.30(3.23,14.32)]、新生兒窒息率較低[RR(95%CI)為0.44(0.33,0.59)],但孕婦不良事件發生率高于基礎治療組[RR(95%CI)為4.57(1.34,15.54)]。與硫酸鎂組相比,沙丁胺醇組保胎超過48 h的孕婦數、新生兒窒息率OR(95%CI)分別為1.60(0.92,2.76),0.29(0.14,0.61)。與阿托西班相比,沙丁胺醇保胎超過48 h的孕婦數、新生兒窒息率OR(95%CI)分別為1.18 (0.42,3.37),1.13(0.30,4.31)。
結論 與基礎治療相比,沙丁胺醇在提高保胎成功率、降低新生兒窒息率方面優于后者,但孕婦不良事件發生率較基礎治療高;沙丁胺醇與其他常用保胎藥相比,在保胎成功率方面無明顯差異,在降低新生兒窒息率方面優于硫酸鎂,孕婦不良事件較阿托西班高,較硫酸鎂低。
引用本文: 閔光寧,劉芳,翟所迪,朱勁松,張虹,王婷,閔光濤. 沙丁胺醇治療孕婦早產的系統評價. 中國循證醫學雜志, 2007, 07(8): 591-600. doi: 復制
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2. | Chen SX, Yang PH, Lv SY. Clinical observation of magnesium sulfate coadunation albuterol sulfate treatment threatened premature labor. Chinese Journal of Clinical Obstetric and Gynecology, 2005, 6(6): 456-457. |
3. | Xia ML. Clinical observation of magnesium sulfate coadunation albuterol sulfate treatment threatened premature labor. Contemporary Medicine , 2006, (10): 88-89. |
4. | Chen DL. Clinical observation of albuterol sulfate treatment premature labor of 35 cases. Journal of Guiyang Medical College, 1996, 21(2): 144-145. |
5. | Li DM, Zhou XD. Observations on treatment of premature labor with salbutamol sulphate - an analysis of 45 cases. Journal of Shanxi Medical College for Continuing Educatlon, 1997, 7(2): 11-13. |
6. | Ying XY. Salbutamol treatment premature labor. Academic Journal of Kaifeng Medical College, 1998, 17(1): 11-13. |
7. | Teng JF. Effect analysis of albuterol sulfate treatment premature labor. Qingdao Medical Journal , 1998, 30(12): 42. |
8. | Xiao QG. Clinical observation of albuterol sulfate treatment premature labor of 66 cases. Maternal and Child Health Care of China, 2003, 18(6): 374. |
9. | Wang JF. Clinical observation of albuterol sulfate treatment premature labor of 74 cases. Central Plains Medical Journal, 2004, 31(15): 49-50. |
10. | Gao XF. Clinical observation of albuterol sulfate treatment premature labor of 54 cases. Proceeding of Clinical Medicine, 2006, 15(8): 629-630. |
11. | Xing LY. Clinical observation of albuterol sulfate treatment premature labor of 48 cases. Shanxi Medical Journal, 1999, 28(6): 373. |
12. | Li Y, Ma YH. Application of salbutamol treatment threatened premature labor. Henan Medical Information, 2001, 9(8): 64. |
13. | Yu DF. Study of magnesium sulfate, salbutamol treatment premature labor of 48 cases. Acta Academidae Medicinae Suzhou, 1995, 15(2): 346. |
14. | Jin YJ. Clinical observation of albuterol sulfate treatment premature labor of 108 cases. Modern Medicine & Health, 2006, 22(11): 1693-1694. |
15. | Liu WQ, Yu LX, Zhu P. Clinical observation of nifedipine treatment premature labor.Qingdao Medical Journal, 1996, 28(9): 12-13. |
16. | Zhao RX, Liu YY, Li LJ. Efficacy of nifedipine in management of premature labor. Clinical Misdiagnosis & Mistherapy, 2006, 19(3): 6-7. |
17. | Xiang J. Clinical observation of nifedipine treatment premature labor . Medical Journal of Communications, 2003, 17(6) : 704-705. |
18. | Wang ZX. Report of albuterol sulfate treatment premature labor of 54 cases. Chinese Journal of Rural Medicine and Pharmacy, 1997, 4(7): 17. |
19. | Liu DY. Treatment premature labor—An analysis of 146 cases. Anthology of Medicine, 2005, 24 (4): 548-549. |
20. | Chen JZ, Cao ZX, Wu WX. Inhibitor of uterine contraction treatment threatened premature labor of 146 cases. Chongqing Medical Journal, 1990, 19(3): 19-20. |
21. | Am J Obstet Gynecol, 2004, 191(3): 683-690. |
22. | Guyer B, Strobino DM, Ventura SJ, et al. Annual summary in vital statistics: 1995. Pediatrics 1996; 98: 1007-1019. Bibliographic Links Library Holdings. |
23. | Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials, 1996 , 17(1): 1-12. |
24. | 江雪華. 硫酸鎂、硫酸舒喘靈交替使用治療早產臨床觀察. 淮海醫藥, 2004, 22(6): 452~453. |
25. | 陳淑霞, 楊培紅, 呂素英. 硫酸鎂聯合硫酸舒喘靈治療先兆早產臨床觀察. 中國婦產科臨床雜志, 2005, 6(6): 456~457. |
26. | 夏麗美. 硫酸鎂聯合硫酸舒喘靈治療先兆早產臨床觀察. 當代醫學, 2006, (10): 88~89. |
27. | 陳達麗. 硫酸舒喘靈治療早產35例療效觀察. 貴陽醫學院學報, 1996, 21(2): 144~145. |
28. | 李冬梅, 周銜弟. 硫酸舒喘靈治療早產45例臨床觀察. 山西職工醫學院學報, 1997, 7(2): 11~13. |
29. | 尹學英. 硫酸舒喘靈在早產治療中的應用. 河南大學學報(醫學科學版), 1998, 17(1): 11~13. |
30. | 滕金鳳. 硫酸舒喘靈治療早產效果分析. 青島醫藥衛生, 1998, 30(12): 42. |
31. | 肖秋桂. 硫酸舒喘靈治療早產66例療效觀察. 中國婦幼保健, 2003, 18(6): 374. |
32. | 王進鳳. 硫酸舒喘靈治療早產74例臨床報告. 中原醫刊, 2004, 31(15): 49~50. |
33. | 高曉芳. 硫酸舒喘靈治療早產54例療效觀察. 臨床醫藥實踐雜志, 2006, 15(8): 629~630. |
34. | 邢蘭瑛. 硫酸舒喘靈治療早產48例療效觀察. 陜西醫學雜志, 1999, 28(6): 373. |
35. | 李巖, 馬玉紅. 硫酸舒喘靈在先兆早產中的應用. 河南醫藥信息, 2001, 9(8): 64. |
36. | 于德鳳. 硫酸鎂、舒喘靈治療早產142例報告. 蘇州醫學院學報, 1995, 15(2): 346. |
37. | 金玉杰. 硫酸舒喘靈治療108例早產的臨床觀察. 現代醫藥衛生, 2006, 22(11): 1693~1694. |
38. | 劉維琴, 于麗霞, 朱萍. 硝苯吡啶治療早產的效果觀察. 青島醫藥衛生, 1996, 28(9): 12~13. |
39. | 趙榮銜, 劉元昀, 李麗君. 硝苯地平治療早產的療效觀察. 臨床誤診誤治, 2006, 19(3): 6~7. |
40. | 向京. 硝苯吡啶治療早產的臨床觀察. 交通醫學, 2003, 17(6): 704~705. |
41. | 王澤香. 硫酸舒喘靈治療早產54例報告. 中國鄉村醫藥, 1997, 4(7): 17. |
42. | 劉冬艷. 146例早產婦治療分析. 醫學文選, 2005, 24(4): 548~549. |
43. | 梁淑花. 硫酸舒喘靈治療45例先兆早產療效觀察. 航空航天醫藥, 2004, (1): 37.Liang SH. Effect of albuterol sulfate treatment premature labor of 45 Cases. Aerospace Medicine, 2004, (1): 37. |
44. | 陳建宗, 曹珍修, 吳味辛. 先兆早產宮縮抑制劑治療63例分析. 重慶醫藥, 1990, 19(3): 19~20. |
45. | Jannet D, Abankwa A, Guyard B, et al. Nicardipine versus salbutamol in the treatment of premature labor. A prospective randomized study. Eur J Obstet Gynecol Reprod Biol, 1997, 73(1): 11-16. |
46. | French/Australian Atosiban Investigators Group. Treatment of preterm labor with the oxytocin antagonist atosiban: a double-blind, randomized, controlled comparison with salbutamol. Eur J Obstet Gynecol Reprod Biol, 2001, 98(2): 177-185. |
47. | Bisits A, Madsen G, Knox M, et al. The Randomized Nitric Oxide Tocolysis Trial (RNOTT) for the treatment of preterm labor. |
48. | Anotayanonth S, Subhedar NV, Garner P, et al. Betamimetics for inhibiting preterm labour. Cochrane Database Syst Rev, 2004, (4): CD004352. |
- 1. Jiang XH. Clinical observation of alternative use of magnesium sulfate and sulfuric acid to cure the prematurity. Journal of Huaihai Medicine, 2004, 22(6): 452-453.
- 2. Chen SX, Yang PH, Lv SY. Clinical observation of magnesium sulfate coadunation albuterol sulfate treatment threatened premature labor. Chinese Journal of Clinical Obstetric and Gynecology, 2005, 6(6): 456-457.
- 3. Xia ML. Clinical observation of magnesium sulfate coadunation albuterol sulfate treatment threatened premature labor. Contemporary Medicine , 2006, (10): 88-89.
- 4. Chen DL. Clinical observation of albuterol sulfate treatment premature labor of 35 cases. Journal of Guiyang Medical College, 1996, 21(2): 144-145.
- 5. Li DM, Zhou XD. Observations on treatment of premature labor with salbutamol sulphate - an analysis of 45 cases. Journal of Shanxi Medical College for Continuing Educatlon, 1997, 7(2): 11-13.
- 6. Ying XY. Salbutamol treatment premature labor. Academic Journal of Kaifeng Medical College, 1998, 17(1): 11-13.
- 7. Teng JF. Effect analysis of albuterol sulfate treatment premature labor. Qingdao Medical Journal , 1998, 30(12): 42.
- 8. Xiao QG. Clinical observation of albuterol sulfate treatment premature labor of 66 cases. Maternal and Child Health Care of China, 2003, 18(6): 374.
- 9. Wang JF. Clinical observation of albuterol sulfate treatment premature labor of 74 cases. Central Plains Medical Journal, 2004, 31(15): 49-50.
- 10. Gao XF. Clinical observation of albuterol sulfate treatment premature labor of 54 cases. Proceeding of Clinical Medicine, 2006, 15(8): 629-630.
- 11. Xing LY. Clinical observation of albuterol sulfate treatment premature labor of 48 cases. Shanxi Medical Journal, 1999, 28(6): 373.
- 12. Li Y, Ma YH. Application of salbutamol treatment threatened premature labor. Henan Medical Information, 2001, 9(8): 64.
- 13. Yu DF. Study of magnesium sulfate, salbutamol treatment premature labor of 48 cases. Acta Academidae Medicinae Suzhou, 1995, 15(2): 346.
- 14. Jin YJ. Clinical observation of albuterol sulfate treatment premature labor of 108 cases. Modern Medicine & Health, 2006, 22(11): 1693-1694.
- 15. Liu WQ, Yu LX, Zhu P. Clinical observation of nifedipine treatment premature labor.Qingdao Medical Journal, 1996, 28(9): 12-13.
- 16. Zhao RX, Liu YY, Li LJ. Efficacy of nifedipine in management of premature labor. Clinical Misdiagnosis & Mistherapy, 2006, 19(3): 6-7.
- 17. Xiang J. Clinical observation of nifedipine treatment premature labor . Medical Journal of Communications, 2003, 17(6) : 704-705.
- 18. Wang ZX. Report of albuterol sulfate treatment premature labor of 54 cases. Chinese Journal of Rural Medicine and Pharmacy, 1997, 4(7): 17.
- 19. Liu DY. Treatment premature labor—An analysis of 146 cases. Anthology of Medicine, 2005, 24 (4): 548-549.
- 20. Chen JZ, Cao ZX, Wu WX. Inhibitor of uterine contraction treatment threatened premature labor of 146 cases. Chongqing Medical Journal, 1990, 19(3): 19-20.
- 21. Am J Obstet Gynecol, 2004, 191(3): 683-690.
- 22. Guyer B, Strobino DM, Ventura SJ, et al. Annual summary in vital statistics: 1995. Pediatrics 1996; 98: 1007-1019. Bibliographic Links Library Holdings.
- 23. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials, 1996 , 17(1): 1-12.
- 24. 江雪華. 硫酸鎂、硫酸舒喘靈交替使用治療早產臨床觀察. 淮海醫藥, 2004, 22(6): 452~453.
- 25. 陳淑霞, 楊培紅, 呂素英. 硫酸鎂聯合硫酸舒喘靈治療先兆早產臨床觀察. 中國婦產科臨床雜志, 2005, 6(6): 456~457.
- 26. 夏麗美. 硫酸鎂聯合硫酸舒喘靈治療先兆早產臨床觀察. 當代醫學, 2006, (10): 88~89.
- 27. 陳達麗. 硫酸舒喘靈治療早產35例療效觀察. 貴陽醫學院學報, 1996, 21(2): 144~145.
- 28. 李冬梅, 周銜弟. 硫酸舒喘靈治療早產45例臨床觀察. 山西職工醫學院學報, 1997, 7(2): 11~13.
- 29. 尹學英. 硫酸舒喘靈在早產治療中的應用. 河南大學學報(醫學科學版), 1998, 17(1): 11~13.
- 30. 滕金鳳. 硫酸舒喘靈治療早產效果分析. 青島醫藥衛生, 1998, 30(12): 42.
- 31. 肖秋桂. 硫酸舒喘靈治療早產66例療效觀察. 中國婦幼保健, 2003, 18(6): 374.
- 32. 王進鳳. 硫酸舒喘靈治療早產74例臨床報告. 中原醫刊, 2004, 31(15): 49~50.
- 33. 高曉芳. 硫酸舒喘靈治療早產54例療效觀察. 臨床醫藥實踐雜志, 2006, 15(8): 629~630.
- 34. 邢蘭瑛. 硫酸舒喘靈治療早產48例療效觀察. 陜西醫學雜志, 1999, 28(6): 373.
- 35. 李巖, 馬玉紅. 硫酸舒喘靈在先兆早產中的應用. 河南醫藥信息, 2001, 9(8): 64.
- 36. 于德鳳. 硫酸鎂、舒喘靈治療早產142例報告. 蘇州醫學院學報, 1995, 15(2): 346.
- 37. 金玉杰. 硫酸舒喘靈治療108例早產的臨床觀察. 現代醫藥衛生, 2006, 22(11): 1693~1694.
- 38. 劉維琴, 于麗霞, 朱萍. 硝苯吡啶治療早產的效果觀察. 青島醫藥衛生, 1996, 28(9): 12~13.
- 39. 趙榮銜, 劉元昀, 李麗君. 硝苯地平治療早產的療效觀察. 臨床誤診誤治, 2006, 19(3): 6~7.
- 40. 向京. 硝苯吡啶治療早產的臨床觀察. 交通醫學, 2003, 17(6): 704~705.
- 41. 王澤香. 硫酸舒喘靈治療早產54例報告. 中國鄉村醫藥, 1997, 4(7): 17.
- 42. 劉冬艷. 146例早產婦治療分析. 醫學文選, 2005, 24(4): 548~549.
- 43. 梁淑花. 硫酸舒喘靈治療45例先兆早產療效觀察. 航空航天醫藥, 2004, (1): 37.Liang SH. Effect of albuterol sulfate treatment premature labor of 45 Cases. Aerospace Medicine, 2004, (1): 37.
- 44. 陳建宗, 曹珍修, 吳味辛. 先兆早產宮縮抑制劑治療63例分析. 重慶醫藥, 1990, 19(3): 19~20.
- 45. Jannet D, Abankwa A, Guyard B, et al. Nicardipine versus salbutamol in the treatment of premature labor. A prospective randomized study. Eur J Obstet Gynecol Reprod Biol, 1997, 73(1): 11-16.
- 46. French/Australian Atosiban Investigators Group. Treatment of preterm labor with the oxytocin antagonist atosiban: a double-blind, randomized, controlled comparison with salbutamol. Eur J Obstet Gynecol Reprod Biol, 2001, 98(2): 177-185.
- 47. Bisits A, Madsen G, Knox M, et al. The Randomized Nitric Oxide Tocolysis Trial (RNOTT) for the treatment of preterm labor.
- 48. Anotayanonth S, Subhedar NV, Garner P, et al. Betamimetics for inhibiting preterm labour. Cochrane Database Syst Rev, 2004, (4): CD004352.