高剂量和低剂量重组人促红细胞生成素对早产儿神经发育的疗效和安全性：一项荟萃分析。

Efficacy and safety of high and low dose recombinant human erythropoietin on neurodevelopment of premature infants: A meta-analysis.

作者信息

Qin Na, Qin Huibin

机构信息

Heping Hospital Affiliated to Changzhi Medical College, Changzhi City, Shanxi Province, China.

出版信息

Medicine (Baltimore). 2021 May 7;100(18):e25805. doi: 10.1097/MD.0000000000025805.

DOI:10.1097/MD.0000000000025805

PMID:33950982

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8104141/

Abstract

BACKGROUND

To evaluate the effect of recombinant human erythropoietin (rhEPO) in nervous system of premature infants including different dosage.

METHODS

The multiple databases like Pubmed, Embase, Cochrane databases and China National Knowledge Database were used to search for the relevant studies, and full-text articles involved in the evaluation on effect of rhEPO for neurodevelopment among premature infants. Review Manager 5.2 was adopted to estimate the effects of the results among selected articles. Forest plots, sensitivity analysis and bias analysis for the articles included were also conducted.

RESULTS

Finally, 10 eligible studies were eventually satisfied the included criteria. The results showed that rhEPO was much higher than placebo group in composite cognitive score (MD = 5.89, 95% confidential interval {CI} [1.95, 9.82], P = .003; I2 = 89%), there was no significant difference between rhEPO and placebo groups (RR = 0.93, 95% CI [0.60, 1.43], P = .74; I2 = 51%) and no difference in neurodevelopmental impairment between rhEPO and placebo was insignificant (RR = 0.55 95% CI [0.30, 1.02], P = .06). Composite cognitive score in high dose rhEPO was much higher than placebo group (MD = 10.39, 95% CI [8.84, 11.93], P < .0001, I2 = 0%) and low dose rhEPO also had higher composite cognitive score than placebo group (MD = 2.58, 95% CI [0.80, 4.37], P = .004, I2 = 11%). Limited publication bias was observed in this study.

CONCLUSION

Recombinant human erythropoietin might be a promotor for neurodevelopment among premature infants with limited adverse events.

摘要

背景

评估重组人促红细胞生成素（rhEPO）对早产儿神经系统的影响，包括不同剂量的影响。

方法

使用多个数据库，如PubMed、Embase、Cochrane数据库和中国知网，搜索相关研究，以及涉及评估rhEPO对早产儿神经发育影响的全文文章。采用Review Manager 5.2对所选文章的结果进行效应估计。还对纳入的文章进行了森林图、敏感性分析和偏倚分析。

结果

最终，10项符合条件的研究最终满足纳入标准。结果显示，rhEPO组的综合认知评分远高于安慰剂组（MD = 5.89，95%置信区间{CI}[1.95, 9.82]，P = 0.003；I² = 89%），rhEPO组与安慰剂组之间无显著差异（RR = 0.93，95% CI[0.60, 1.43]，P = 0.74；I² = 51%），且rhEPO组与安慰剂组在神经发育障碍方面的差异不显著（RR = 0.55，95% CI[0.30, 1.02]，P = 0.06）。高剂量rhEPO组的综合认知评分远高于安慰剂组（MD = 10.39，95% CI[8.84, 11.93]，P < 0.0001，I² = 0%），低剂量rhEPO组的综合认知评分也高于安慰剂组（MD = 2.58，95% CI[0.80, 4.37]，P = 0.004，I² = 11%）。本研究观察到有限的发表偏倚。