硝苯地平在早产治疗中的应用：系统评价和荟萃分析。
Nifedipine in the management of preterm labor: a systematic review and metaanalysis.
机构信息
Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
出版信息
Am J Obstet Gynecol. 2011 Feb;204(2):134.e1-20. doi: 10.1016/j.ajog.2010.11.038.
Abstract
OBJECTIVE
To determine the efficacy and safety of nifedipine as a tocolytic agent in women with preterm labor.
STUDY DESIGN
A systematic review and metaanalysis of randomized controlled trials.
RESULTS
Twenty-six trials (2179 women) were included. Nifedipine was associated with a significant reduction in the risk of delivery within 7 days of initiation of treatment and before 34 weeks' gestation, respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, neonatal jaundice, and admission to the neonatal intensive care unit when compared with β₂-adrenergic-receptor agonists. There was no difference between nifedipine and magnesium sulfate in tocolytic efficacy. Nifedipine was associated with significantly fewer maternal adverse events than β₂-adrenergic-receptor agonists and magnesium sulfate. Maintenance nifedipine tocolysis was ineffective in prolonging gestation or improving neonatal outcomes when compared with placebo or no treatment.
CONCLUSION
Nifedipine is superior to β₂-adrenergic-receptor agonists and magnesium sulfate for tocolysis in women with preterm labor.
摘要
目的
评估硝苯地平治疗早产孕妇的疗效和安全性。
研究设计
系统评价和荟萃分析随机对照试验。
结果
共纳入 26 项试验（2179 名女性）。与β₂-肾上腺素能受体激动剂相比，硝苯地平治疗开始后 7 天内和 34 周前分娩、呼吸窘迫综合征、坏死性小肠结肠炎、脑室出血、新生儿黄疸和新生儿重症监护病房入院的风险显著降低。硝苯地平与硫酸镁在保胎效果方面没有差异。硝苯地平与β₂-肾上腺素能受体激动剂和硫酸镁相比，母亲不良事件明显较少。与安慰剂或不治疗相比，维持性硝苯地平保胎并不能延长妊娠时间或改善新生儿结局。
结论
硝苯地平治疗早产孕妇的保胎效果优于β₂-肾上腺素能受体激动剂和硫酸镁。
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