国际妇产科学杂志

国际妇产科学杂志 ›› 2014, Vol. 41 ›› Issue (6): 686-691.

• 论著 • 上一篇    下一篇

缩宫素受体拮抗剂与β受体激动剂治疗早产的Meta分析

杨光琼，龙书玉，杨沛，杨星亮，李华风   

  1. 610041 四川大学华西第二医院（杨光琼，龙书玉，杨沛，李华风）；第三军医大学新桥医院（杨星亮）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-12-15 发布日期:2014-12-15

Oxytocin Receptor Inhibitors and β-receptor Agonist in the Treatment of Premature Delivery：a Meta-Analysis

YANG Guang-qiong，LONG Shu-yu，YANG Pei，YANG Xing-liang，LI Hua-feng   

  1. West China Second University Hospital，Chongqing 610041，China（YANG Guang-qiong，LONG Shu-yu，YANG Pei，LI Hua-feng）；Xin Qiao Hospital，Third Military Medical Univerisity，Chengdu 400038，China（YANG Xing-liang）
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-12-15 Online:2014-12-15

PDF (PC)

4708

摘要： 目的：评价缩宫素受体拮抗剂和β受体激动剂治疗妊娠妇女早产的效果和安全性。方法：计算机检索相关数据库，全面收集缩宫素受体拮抗剂阿托西班与β受体激动剂（包括利托君，沙丁胺醇，沙布他林）比较治疗早产的随机临床试验，对符合纳入标准的临床研究进行Meta分析，应用Cochrane协作网提供的Revman 5.0软件进行数据处理。结果：共纳入6篇文献，2组阿托西班和β受体激动剂延长孕周48 h人数（RR=1.00，95%CI为0.97～1.04，P=0.90）和孕周7 d人数（RR=1.04，95%CI为0.99～1.09，P=0.14）的差异无统计学意义；2组新生儿出生胎龄（WMD=0.18，95%CI为-0.19～0.55，P=0.34）和出生时平均体质量（WMD=-33.89，95%CI为-108.57～40.79，P=0.37）差异也无统计学意义。但在耐受性及效力上，即48 h内（RR=1.07，95%CI为1.01～1.14，P=0.03）及7 d内（RR=1.25，95%CI为1.14～1.37，P＜0.05）未分娩且不需其他保胎药差异有统计学意义；在母体不良反应尤其是心动过速发生率上差异有统计学意义（RR=0.09，95%CI为0.05～0.17，P＜0.000 01）；2组因母体发生不良反应而停药的人数差异也有统计学意义（RR=0.08，95%CI为0.05～0.14，P＜0.000 01）。结论：阿托西班在治疗早产方面可以达到β受体激动剂相似的治疗效果，但是在耐受性上比β受体激动剂强，且母体不良反应发生率较少。

关键词: 催产素, 早产, Meta分析, 治疗

Abstract: Objective：To evaluate and compare the effects and safety of the oxytocin receptor inhibitors and β-receptor agonist in the treatment of premature delivery. Methods：Based on searching the related literatures from the database by computer，we do a comprehensive collection of randomized trial comparing treatments on the oxytocin receptor inhibitor Atosiban and β receptor agonists including Ritodrine，Salbutamol，Terbutaline. Besides，we do Meta-analysis to the clinical research meeting the inclusive criteria，then we use Cochrane Collaboration RevMan 5.0 software for data processing. Results：A total of six literatures has been identified，Atosiban and β-receptor agonist in the extended gestation of 48 h（RR=1.00，95%CI：0.97-1.04，P=0.90），7 d（RR=1.04，95%CI：0.99-1.09，P=0.14），the difference of the above two groups was not statistically significant; There was no significant difference between the Atosiban group and β-receptor agonist group in gestational age at birth（WMD=0.18，95%CI：-0.19-0.55，P=0.34） and the average weight at birth（WMD=-33.89，95%CI：-108.57-40.79，P=0.37）. However，as to tolerability and efficacy，un-delivery within the 48h and requiring no other tocolytic agent（RR=1.07，95%CI：1.01-1.14，P=0.03） and un-delivery within 7 d and needing no other miscarriage drugs（RR=1.25，95%CI：1.14-1.37，P＜0.05） difference of the Atosiban group and β-receptor agonist group was statistically significant; and incidence of side effects in the mother，especially tachycardia has significant difference（RR=0.09，95%CI：0.05-0.17，P＜0.000 01）；differences in the number of discontinuation people due to side effects of maternal between the Atosiban group and β-agonist group was significant（RR=0.08，95%CI：0.05-0.14，P＜0.000 01）. Conclusions：Compared with β-agonist，Atosiban can achieve the similar therapeutic effect in the treatment of premature delivery，however，its tolerance is much stronger than the β-agonist and incidence of side effects in maternal is much less.

Key words: Oxytocin, Premature birth, Meta-analysis, Therapy