Zhang Zhi-Qun, Huang Xian-Mei, Lu Hui
Department of Pediatrics, Hangzhou First People's Hospital, Hangzhou 320006, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2010 Nov;12(11):858-63.
To evaluate the efficacy and safety of ambroxol in the prevention of respiratory distress syndrome (RDS) in preterm infants.
Electronic searches were performed in the Cochrane Library, PubMED, EMBASE, Chinese CBM, Chinese VIP Database, Chinese Wanfang Database and Chinese CNKI Database up to the year of 2009 for randomized controlled trials (RCT) on ambroxol for the prevention of RDS in preterm infants. The meeting articles related to the RCT were manually searched in Pediatrics and Pediatric Research. Meta analysis was performed for the results of homogeneous studies by the Cochrane Collaboration's software RevMan 5.0.17.
Six RCTs involving 823 preterm infants were included, and the quality assessment for the trials demonstrated 1 article as A class, 1 article as B class and 4 articles as C class. The Meta analysis showed that ambroxol administration significantly reduced the incidence of RDS (OR=0.24, 95%CI: 0.15 - 0.64, P<0.01), bronchopulmonary dysplasis (BPD, OR=0.41, 95%CI: 0.23 - 0.75, P<0.01), intraventricular hemorrhage (IVH, OR=0.39, 95%CI:0.24 - 0.64, P<0.01), patent ductus arteriosus (PDA, OR=0.33, 95%CI: 0.17 - 0.67, P<0.01) and pulmonary infection (OR=0.24, 95%CI:0.14 - 0.38, P<0.01). No adverse events related to the ambroxol treatment were reported.
The current evidence shows that early use of ambroxol can reduce the risk of RDS, BPD, IVH, PDA and pulmonary infection in preterm infants.
评估氨溴索预防早产儿呼吸窘迫综合征(RDS)的疗效和安全性。
截至2009年,在考克兰图书馆、PubMED、EMBASE、中国生物医学文献数据库、中文科技期刊数据库、中国万方数据库和中国知网数据库中进行电子检索,查找关于氨溴索预防早产儿RDS的随机对照试验(RCT)。在《儿科学》和《儿科研究》中手动检索与RCT相关的会议文章。采用考克兰协作网的RevMan 5.0.17软件对同质研究结果进行Meta分析。
纳入6项涉及823例早产儿的RCT,试验质量评估显示1篇为A级,1篇为B级,4篇为C级。Meta分析表明,使用氨溴索可显著降低RDS(OR = 0.24,95%CI:0.15 - 0.64,P < 0.01)、支气管肺发育不良(BPD,OR = 0.41,95%CI:0.23 - 0.75,P < 0.01)、脑室内出血(IVH,OR = 0.39,95%CI:0.24 - 0.64,P < 0.01)、动脉导管未闭(PDA,OR = 0.33,95%CI:0.17 - 0.67,P < 0.01)及肺部感染(OR = 0.24,95%CI:0.14 - 0.38,P < 0.01)的发生率。未报告与氨溴索治疗相关的不良事件。
现有证据表明,早期使用氨溴索可降低早产儿发生RDS、BPD、IVH、PDA及肺部感染的风险。