Department of Neonatology, General Hospital of the Northern Theater of the Chinese People's Liberation Army, Shenyang 110016, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2022 Mar 15;24(3):319-325. doi: 10.7499/j.issn.1008-8830.2109151.
To systematically evaluate the efficacy and safety of bosentan in the treatment of persistent pulmonary hypertension of the newborn (PPHN).
Chinese Journal Full-text Database, Weipu Database, Wanfang Data, China Biology Medicine disc, PubMed, Web of Science, Embase, and Cochrane Library were searched for literature on bosentan in the treatment of PPHN published up to August 31, 2021.
A total of 8 randomized controlled trials were included for Meta analysis. The results of the Meta analysis showed that compared with the control group, the bosentan treatment group had a significantly lower treatment failure rate (=0.23, <0.001), a significantly greater reduction in pulmonary artery pressure [mean difference ()=-11.79, <0.001)], significantly greater increases in oxygen partial pressure (=10.21, =0.006) and blood oxygen saturation (=8.30, <0.001), and a significantly shorter length of hospital stay (=-1.35, <0.001). The descriptive analysis showed that the bosentan treatment group had a lower degree of tricuspid regurgitation than the control group after treatment. The main adverse reactions of bosentan treatment included abnormal liver function, anemia and edema. The results of subgroup analysis based on treatment regimen, research area, and drug dose were consistent with those before stratification.
Bosentan is effective in the treatment of PPHN. However, when using bosentan, attention should be paid to adverse reactions such as abnormal liver function.
系统评价波生坦治疗新生儿持续性肺动脉高压(PPHN)的疗效和安全性。
计算机检索中国期刊全文数据库、维普数据库、万方数据知识服务平台、中国生物医学文献数据库、PubMed、Web of Science、Embase 和 Cochrane Library,检索时限均为建库至 2021 年 8 月 31 日,收集关于波生坦治疗 PPHN 的随机对照试验,对符合纳入标准的文献进行 Meta 分析。
共纳入 8 项随机对照试验进行 Meta 分析。Meta 分析结果显示,与对照组相比,波生坦治疗组治疗失败率更低[比值比(OR)=0.23,<0.001],肺动脉压下降更明显[均数差(MD)=-11.79,<0.001],氧分压升高更显著[MD=10.21,=0.006],血氧饱和度升高更明显[MD=8.30,<0.001],住院时间更短[MD=-1.35,<0.001];描述性分析结果显示,治疗后波生坦治疗组三尖瓣反流程度较对照组轻。波生坦治疗的主要不良反应包括肝功能异常、贫血和水肿。基于治疗方案、研究区域和药物剂量的亚组分析结果与分层前一致。
波生坦治疗 PPHN 有效,但使用时应注意肝功能异常等不良反应。