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系统评价与荟萃分析：支气管肺发育不良对极低出生体重早产儿神经发育的影响

Systematic review and meta-analysis: the effect of bronchopulmonary dysplasia on neurodevelopment in very low birth weight premature infants.

作者信息

Gao Shuqiang, Zhang Xiaolong, Du Weina, Zhou Xiaofeng, Xi Yufeng, Ju Rong

机构信息

Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Transl Pediatr. 2021 Nov;10(11):3023-3033. doi: 10.21037/tp-21-449.

DOI:10.21037/tp-21-449
PMID:34976768
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8649609/
Abstract

BACKGROUND: A meta-analysis was performed to study the effect of steroid intervention on the neurodevelopment of extremely low birth weight preterm infants complicated with bronchopulmonary dysplasia, and to provide a theoretical basis for clinical treatment. METHODS: The Wanfang database, Chinese Biomedical Literature database, VIP database, Baidu Academic, CNKI database, The Cochrane Library, Medline, Embase, and PubMed database were searched by computer from establishment to 2021. Randomized controlled trials on the effect of steroids on neurodevelopment in very low birth weight preterm infants with bronchial dysplasia published from January 10, 2007 were retrieved. The included literature was evaluated for bias risk, then analyzed using RevMan 5.3 software. RESULTS: A total of 9 studies were included, with a total of 2,453 patients. The funnel plot showed that the circles and the midline of some studies were basically symmetrical, and there was no bias in the publications. The conclusions obtained were relatively reliable. Cerebral palsy, neurodevelopmental indicators, and MRI findings of preterm infants were analyzed. The cognitive impairment of very low birth weight preterm infants complicated with bronchial dysplasia (RR =0.83, 95% CI: 0.72-0.96, P=0.01) in the treatment group was significantly different from that in the control group, while cerebral palsy (RR =0.99, 95% CI: 0.75-1.29, P=0.93), speech impairment (RR =0.75, 95% CI: 0.46-1.21, P=0.24), hearing loss requiring amplification (RR =0.60, 95% CI: 0.35-1.03, P=0.06), bilateral blindness RR =0.81, 95% CI: 0.52-1.24, P=0.32), severe intraventricular hemorrhage (IVH) (RR =0.71, 95% CI: 0.33-1.50, P=0.37), and cystic periventricular leukomalacia (RR =0.82, 95% CI: 0.43-1.57, P=0.56) had no significant differences compared with the control group. DISCUSSION: In this meta-analysis, we found that the use of steroids in very low birth weight preterm infants complicated with bronchial dysplasia had significant effects on cognition, but no significant effects on hearing, vision, or language function.

摘要

背景：进行一项荟萃分析，以研究类固醇干预对极低出生体重早产儿合并支气管肺发育不良神经发育的影响，为临床治疗提供理论依据。 方法：通过计算机检索万方数据库、中国生物医学文献数据库、维普数据库、百度学术、知网数据库、考克兰图书馆、Medline、Embase和PubMed数据库，检索时间从建库至2021年。检索2007年1月10日以来发表的关于类固醇对极低出生体重早产儿支气管发育不良神经发育影响的随机对照试验。对纳入文献进行偏倚风险评估，然后使用RevMan 5.3软件进行分析。 结果：共纳入9项研究，共2453例患者。漏斗图显示部分研究的圆圈与中线基本对称，发表无偏倚。得出的结论相对可靠。对早产儿的脑瘫、神经发育指标和MRI结果进行分析。治疗组极低出生体重早产儿合并支气管发育不良的认知障碍（RR =0.83，95%CI：0.72 - 0.96，P =0.01）与对照组有显著差异，而脑瘫（RR =0.99，95%CI：0.75 - 1.29，P =0.93）、言语障碍（RR =0.75，95%CI：0.46 - 1.21，P =0.24）、需要放大助听器的听力损失（RR =0.60，95%CI：0.35 - 1.03，P =0.06）、双侧失明（RR =0.81，95%CI：0.52 - 1.24，P =0.32）、重度脑室内出血（IVH）（RR =0.71，95%CI：0.33 - 1.50，P =0.37）和脑室周围白质软化囊肿（RR =0.82，95%CI：0.43 - 1.57，P =0.56）与对照组相比无显著差异。 讨论：在这项荟萃分析中，我们发现，在极低出生体重早产儿合并支气管发育不良中使用类固醇对认知有显著影响，但对听力、视力或语言功能无显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b73/8649609/abc0c9212779/tp-10-11-3023-f11.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b73/8649609/62790071a10c/tp-10-11-3023-f7.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b73/8649609/abc0c9212779/tp-10-11-3023-f11.jpg

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引用本文的文献

[1]
Influencing factors and construction of a predictive model for neurodevelopmental outcomes in preterm low birth weight infants.

Am J Transl Res. 2025-7-15

[2]
Dexamethasone Use to Reduce Mechanical Ventilation and Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit.

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[3]
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[1]
Risk factors for intraventricular hemorrhage in premature infants in the central region of Saudi Arabia.

Int J Pediatr Adolesc Med. 2021-6

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Arch Dis Child Fetal Neonatal Ed. 2020-1-24

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