摘要
Abstract
Objective To systematically evaluate the effectiveness and clinical significance of inhaled nitric oxide (iNO) in the prevention and treatment of bronchopulmonary dysplasia(BPD) in premature infants. Methods (1) Papers on iNO in the prevention and treatment of BPD in premature infants based on clinical randomized controlled trial(RCT) of treatment group and placebo or blank control group and quasi-randomized control trial which were retrieved from January 2000 to December 2014 by main medical search database, such as PubMed, Chinese Journal Full Text Database(CJFD), Embase, Vip databases, Medlin, Wanfang Med Online, etc. were collected. (2)The data were extracted by two independent persons, and cross checked. The risk of bias of the included research findings was assessed. (3)Revman 5.2 software was used to carry on systematic analysis. The binary result was analyzed with log binomial regression model, and successive result was systematically analyzed with linear fixed effect model. Results Meta analysis results showed that, (1)Results of different inhalation concentrations. When the inhaled quantity was 5ppm, the BPD Occurred more frequently, the risk ratio(RR) was 0.97, 95% confidence interval(CI) was 0.92-1.02. The mortality rate was not significantly different with that of the control group, the RR was 0.84, the 95%CI was 0.66-1.07. When the inhaled quantity was 10ppm, compared with the control group, the incidence of BPD and mortality rate were not statistically significant. When the inhaled quantity was 20ppm or the titration reaction was taken, the RR of BPD was 1, which showed that the quantity of nitric oxide has no effect on the mortality rate and the incidence of BPD. (2)The iNO results of different birth weight. Compared with the control group, only the comprehensive results of the mortality rate and the incidence of BPD in iNO treatment group of preterm infants with birth weight from 1000g to 1250g was significant(38.5%vs 64.1%), the RR was 0.60, the 95% CI was 0.42-0.86, which showed no effect on the mortality rate or the incidence of BPD. Conclusion There is no necessity of traditional iNO for BPD in premature infants. The iNO may be considered for the premature infants with birth weight from 1000g to 1250g who were still dependence on oxygen 28 days after birth, the optimal inhaled quantity should between 5ppm and 20ppm.关键词
支气管肺发育不良/早产儿/吸入一氧化氮/防治/Meta分析Key words
Bronchopulmonary dysplasia/Premature infants/Inhaled nitric oxide/Prevention and treatment/Meta analysis分类
医药卫生
